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Individual

DR. BRIAN W KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
91-2135 FORT WEAVER RD, SUITE 501, EWA BEACH, HI 96706-1940
(808) 312-6800
(808) 680-0006
Mailing address
91-2135 FORT WEAVER RD, SUITE 501, EWA BEACH, HI 96706-1940
(808) 312-6800
(808) 680-0006

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1353
HI
103TC0700X
Clinical Psychologist
1353
HI

Other

Enumeration date
10/31/2012
Last updated
11/04/2014
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