Individual
MEDINA L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
405 CASTLE CREEK RD STE 9, ASPEN, CO 81611-3125
(970) 920-5555
(970) 920-5557
Mailing address
PO BOX 40, GLENWOOD SPRINGS, CO 81602-0040
(970) 945-2241
(970) 945-5523
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1213
CO
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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