Individual
DR. KEVIN J. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
530 UNION BLVD, ALLENTOWN, PA 18109-3230
(610) 435-1541
(610) 435-4367
Mailing address
530 UNION BLVD, ALLENTOWN, PA 18109-3230
(610) 435-1541
(610) 435-4367
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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