Doctor Name: | DR. MARY E KELLY |
NPI Number: | 1013214832 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 018635 |
Business Practice Address: | 17 Senior St New Brunswick, NJ - 089018534 |
Business Phone Number: | 8489327884 |
Business Fax Number: | 7329328278 |
Mailing Address: | 17 Senior St, NEW BRUNSWICK |
State: | NJ |
Postal Code: | 089018534 |
Phone Number: | 8489327884 |
Fax Number: | 7329328278 |
NPI Enumeration Date: | 02/14/2011 |
NPI Last Update Date: | 07/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 018635 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |