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Individual

KELLY L NEWBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2450 W RIDGE RD STE 303, ROCHESTER, NY 14626-3037
(585) 448-0936
(585) 448-0973
Mailing address
2450 W RIDGE RD STE 303, ROCHESTER, NY 14626-3037
(585) 448-0936
(585) 448-0973

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021789
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00357502
NY
Enumeration date
04/17/2008
Last updated
10/18/2019
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