Individual
KELLY L MCGRAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
9700 PARK PLAZA AVE, SUITE 106, LOUISVILLE, KY 40241-2236
(502) 429-5431
(502) 429-5495
Mailing address
9700 PARK PLAZA AVE, SUITE 106, LOUISVILLE, KY 40241-2236
(502) 429-5431
(502) 429-5495
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1322
KY
103T00000X
Psychologist
6046
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000490468
ANTHEM BCBS
—
Enumeration date
05/10/2006
Last updated
07/08/2007
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