Organization
THERESA KELLAM, PH.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA KELLAM PH.D. (OWNER/PSYCHOLOGIST)
(817) 313-7899
Entity
Organization
Contact information
Practice address
2201 DOTTIE LYNN PKWY, SUITE 127, FORT WORTH, TX 76120-4432
(817) 313-7899
Mailing address
2201 DOTTIE LYNN PKWY, SUITE 127, FORT WORTH, TX 76120-4432
(817) 313-7899
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
32518
TX
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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