Individual
DR. JAMES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
170 PEARL ST SE, ATLANTA, GA 30316-1247
(404) 588-9065
Mailing address
170 PEARL ST SE, ATLANTA, GA 30316-1247
(404) 588-9065
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-05-2292
GA
103TC0700X
Clinical Psychologist
PSY002770
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
875847786B
—
GA
Enumeration date
11/03/2016
Last updated
11/03/2016
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