Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 224529 | MA |
NPI | 1154998250 |
---|---|
Provider Name | Kate Kelley |
First Address | Winthrop, MA 02152-2202 |
Second Address | Winthrop, MA 02152-2202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2021 |
Last Update Date | 07/06/2021 |