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Organization
LAURA KELLISON, PSY,.D.
Active
Organization
LAURA KELLISON, PSY,.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KELLISON PSY.D. (CLINICAL PSYCHOLOGIST)
(707) 364-9388
Entity
Organization
Contact information
Practice address
115 LIBERTY ST, SUITE 4, PETALUMA, CA 94952-2326
(707) 364-9388
Mailing address
115 LIBERTY ST, SUITE 4, PETALUMA, CA 94952-2326
(707) 364-9388
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
19863
CA
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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