| Doctor Name: | MRS. KELLY LOCKHART |
| NPI Number: | 1134517774 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | UA1001668 |
| Business Practice Address: | 17917 Lomond Blvd Shaker Heights, OH - 441225009 |
| Business Phone Number: | 2162954050 |
| Business Fax Number: | |
| Mailing Address: | 15600 Parkland Dr, SHAKER HEIGHTS |
| State: | OH |
| Postal Code: | 441202529 |
| Phone Number: | 2162951400 |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2015 |
| NPI Last Update Date: | 01/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | UA1001668 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |