Provider Demographics
NPI:1801553904
Name:KELLEY-DEMERS, LILYANNA T (LAC)
Entity type:Individual
Prefix:
First Name:LILYANNA
Middle Name:T
Last Name:KELLEY-DEMERS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 KITTERIDGE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-6548
Mailing Address - Country:US
Mailing Address - Phone:207-610-2882
Mailing Address - Fax:
Practice Address - Street 1:53 KITTERIDGE BROOK RD
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-4134
Practice Address - Country:US
Practice Address - Phone:207-610-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC848171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist