| Doctor Name: | DR. KEYONA SHANTRICE THOMAS-KELLY |
| NPI Number: | 1093994949 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D., MA, LCPC |
| License Number: | PRC13986 |
| Business Practice Address: | 14460 Old Mill Rd Suite 201 Upper Marlboro, MD - 207723092 |
| Business Phone Number: | 3013576605 |
| Business Fax Number: | |
| Mailing Address: | 3475 Leonardtown Rd, Suite #206 WALDORF |
| State: | MD |
| Postal Code: | 206013678 |
| Phone Number: | 3013576605 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2007 |
| NPI Last Update Date: | 03/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PRC13986 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |