Individual
KELLY ROSE ILSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, ABPP, BCBA-D
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY7971
FL
Other
Enumeration date
02/01/2010
Last updated
10/29/2019
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