Individual
KELLY WALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
18 BLOSSOM ST, EDISON, NJ 08817-4213
(908) 307-5964
Mailing address
18 BLOSSOM ST, EDISON, NJ 08817-4213
(908) 307-5964
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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