| Doctor Name: | DR. BRIAN W KELLEY |
| NPI Number: | 1104170935 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | 1353 |
| Business Practice Address: | 91-2135 Fort Weaver Rd Suite 501 Ewa Beach, HI - 967061940 |
| Business Phone Number: | 8083126800 |
| Business Fax Number: | 8086800006 |
| Mailing Address: | 91-2135 Fort Weaver Rd, Suite 501 EWA BEACH |
| State: | HI |
| Postal Code: | 967061940 |
| Phone Number: | 8083126800 |
| Fax Number: | 8086800006 |
| NPI Enumeration Date: | 10/31/2012 |
| NPI Last Update Date: | 11/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1353 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |