Individual
MATTHEW KELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
521 E 86TH AVE STE H, MERRILLVILLE, IN 46410
(860) 670-1373
Mailing address
216 WESTWIND DR APT A, MICHIGAN CITY, IN 46360-7877
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071009951
IL
Other
Enumeration date
01/24/2018
Last updated
04/19/2019
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