Individual
DR. KELLI J DEIACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
16287 WILLOW CREEK RD, LEWES, DE 19958-3614
(302) 703-6332
(302) 827-4856
Mailing address
51 W END TRL UNIT 141, MACUNGIE, PA 18062-5003
(610) 462-5585
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC004790
PA
103TC0700X
Clinical Psychologist
B1-0011334
DE
103TC0700X
Clinical Psychologist
Primary
PS018210
PA
Other
Enumeration date
03/05/2008
Last updated
04/18/2025
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