Individual
RUTH KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2461 N STATE HIGHWAY 96, NAUVOO, IL 62354-2200
(217) 453-2232
Mailing address
1 UNIVERSITY CIRCLE, PSYCHOLOGY DEPARTMENT, WESTERN ILLINOIS UNIVERSITY, MACOMB, IL 61455
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
593112
IL
Other
Enumeration date
08/28/2017
Last updated
08/28/2017
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