Organization
SCOTT KELLY & ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT KELLY EDD (PRESIDENT)
(269) 488-5905
Entity
Organization
Contact information
Practice address
3125 W MAIN ST, KALAMAZOO, MI 49006-2997
(269) 488-5905
Mailing address
3125 W MAIN ST, KALAMAZOO, MI 49006-2997
(269) 488-5905
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006856
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301006856
MI PSYCHOLOGIST LICENSE
MI
Enumeration date
02/07/2007
Last updated
08/22/2020
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