Individual
MICHAEL R. KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
10506 BURT CIR, OMAHA, NE 68114-2094
(402) 493-4444
Mailing address
10506 BURT CIR, OMAHA, NE 68114-2094
(402) 493-4444
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470714645-00
—
NE
Enumeration date
07/19/2005
Last updated
07/08/2007
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