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Individual
DR. HRYSSO KELLAS FERNBACH
Active
Individual
DR. HRYSSO KELLAS FERNBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY. D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2705
NJ
103TC0700X
Clinical Psychologist
Primary
26472
CA
103TC0700X
Clinical Psychologist
8643
FL
103TC0700X
Clinical Psychologist
9329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26472
PSYCHOLOGY LICENSE
CA
01
—
2705
PSYCHOLOGY LICENSE
NJ
01
—
9329
PSYCHOLOGY LICENSE
NY
01
—
PY8643
PSYCHOLOGY LICENSE
FL
Enumeration date
06/12/2007
Last updated
09/12/2019
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