Individual
SUSAN SCHACK KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8609 GERMANTOWN AVE # 2F, PHILADELPHIA, PA 19118-2863
(646) 265-2484
Mailing address
8609 GERMANTOWN AVE # 2F, PHILADELPHIA, PA 19118-2863
(646) 265-2484
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS016698
PA
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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