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Individual

DR. JANE ELLEN KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
999 HAYNES ST 235, BIRMINGHAM, MI 48009-6702
(248) 203-0191
(248) 932-2949
Mailing address
999 HAYNES ST 235, BIRMINGHAM, MI 48009-6702
(248) 203-0191
(248) 932-2949

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301010052
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
68-0-F3-3238-0
BCBS
MI
Enumeration date
02/12/2007
Last updated
09/04/2015
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