Provider Demographics
NPI:1457926131
Name:HOWARD, KELLEY (MA, CAGS)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MA, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1395
Mailing Address - Country:US
Mailing Address - Phone:603-966-1344
Mailing Address - Fax:
Practice Address - Street 1:36 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1395
Practice Address - Country:US
Practice Address - Phone:603-966-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool