Kelly, Tina M.

Kelly, Tina M. is an sole proprietor health care provider with primary practice located at 145 Moreland Ave , Waterbury CT 06705-2928. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Kelly, Tina M. can be contacted via phone (203) 597-8734.

Contact Information

Primary practice address
145 Moreland Ave Waterbury CT 06705-2928
Phone: (203) 597-8734
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1295364115
LBN Legal business name Kelly, Tina M.
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2020
Last updated Apr 2nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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