Individual
RYAN MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8840 BLAKENEY PROFESSIONAL DR, SUITE 200, CHARLOTTE, NC 28277-6718
(704) 970-4791
Mailing address
8840 BLAKENEY PROFESSIONAL DR, SUITE 200, CHARLOTTE, NC 28277-6718
(704) 970-4791
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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