Individual
DR. CARLA DEE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4100 W KENNEDY BLVD, #214, TAMPA, FL 33609
(813) 289-6502
(813) 207-0022
Mailing address
209 S COOLIDGE AVE, TAMPA, FL 33609
(813) 286-0320
(813) 207-0022
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY0002141
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00073171
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/13/2007
Last updated
07/08/2007
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