Organization
THOMAS M.L. KELLY, ED.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS M. L. KELLY ED.D. (PRESIDENT)
(817) 481-6951
Entity
Organization
Contact information
Practice address
625 W COLLEGE ST, SUITE 109, GRAPEVINE, TX 76051-5283
(817) 481-6951
Mailing address
625 W COLLEGE ST, SUITE 109, GRAPEVINE, TX 76051-5283
(817) 481-6951
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
22126
TX
Other
Enumeration date
06/21/2006
Last updated
08/22/2020
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