Organization
MULTIMODAL THERAPY INSTITUTE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY BERNARD KELLEY PH.D. (COUNSELING PSYCHOLOGIST)
(440) 349-5445
Entity
Organization
Contact information
Practice address
6605 LIMBERLOST CT, SOLON, OH 44139-3100
(440) 349-5445
Mailing address
PO BOX 391662, SOLON, OH 44139-8662
(440) 349-5445
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
2187
OH
103TC1900X
Counseling Psychologist
Primary
2187
OH
103TS0200X
School Psychologist
2187
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320996
—
OH
Enumeration date
08/31/2006
Last updated
10/25/2021
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