Individual
MS. KELLY LYNN BASSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP, M.ED
Contact information
Practice address
1 SHEPPARD RD, SUITE 704, VOORHEES, NJ 08043-4608
(646) 510-1593
Mailing address
1 SHEPPARD RD, SUITE 704, VOORHEES, NJ 08043-4608
(646) 510-1593
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
000913
NY
Other
Enumeration date
07/31/2009
Last updated
11/17/2015
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