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Individual
DR. KEVIN J. KELLEY
Active
Individual
DR. KEVIN J. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
PS005818L
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS005818L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
763740
BLUE SHIELD
PA
Enumeration date
03/10/2007
Last updated
11/03/2014
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