Doctor Name: | MRS. EDILIA P KELLY |
NPI Number: | 1073947990 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LAC |
License Number: | 37AC0017500 |
Business Practice Address: | 22-08 Route 208 Fair Lawn, NJ - 074102609 |
Business Phone Number: | 2019566363 |
Business Fax Number: | |
Mailing Address: | 89 Gate House Ln, EDISON |
State: | NJ |
Postal Code: | 088204011 |
Phone Number: | 2019566363 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2013 |
NPI Last Update Date: | 08/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 37AC0017500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |