Individual
GERALYN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 MILL RUN CT, MEDFORD, NJ 08055-2436
(609) 953-5397
Mailing address
4 MILL RUN CT, MEDFORD, NJ 08055-2436
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6238
CIGNA
—
Enumeration date
03/12/2020
Last updated
11/27/2023
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