Individual
KELLY M. JANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3501 CIVIC CENTER BLVD # 10209, PHILADELPHIA, PA 19104-3820
(267) 425-0169
Mailing address
3501 CIVIC CENTER BLVD # 10209, PHILADELPHIA, PA 19104-3820
(267) 425-0169
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
021059
NY
103G00000X
Clinical Neuropsychologist
Primary
PS018668
PA
Other
Enumeration date
06/15/2015
Last updated
03/27/2020
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