Doctor Name: | DR. LAURA W. KELLY |
NPI Number: | 1316028418 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | PS1046 |
Business Practice Address: | 2400 Hospital Rd Tuskegee, AL - 360835001 |
Business Phone Number: | 3347270550 |
Business Fax Number: | |
Mailing Address: | 2400 Hospital Rd, TUSKEGEE |
State: | AL |
Postal Code: | 360835001 |
Phone Number: | 3343002785 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 09/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS1046 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |