Individual
DR. KIMBERLY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3270 W BIG BEAVER RD, SUITE 400, TROY, MI 48084-2901
(313) 701-7754
(248) 816-2801
Mailing address
3270 W BIG BEAVER RD, SUITE 400, TROY, MI 48084-2901
(313) 701-7754
(248) 816-2801
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301012132
MI
103TC1900X
Counseling Psychologist
6301012132
MI
Other
Enumeration date
05/17/2007
Last updated
12/17/2012
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