Individual
CITRUS LAMAR PHILLIP KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7109 DANNY DR, STOCKTON, CA 95210-5320
(209) 957-7777
Mailing address
736 S WASHINGTON ST, LODI, CA 95240-4820
(209) 327-3613
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
12/03/2024
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