Individual
KATHRYN NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
101 SOUTH GRAHAM AVENUE, CARBONDALE, IL 62901-3001
(618) 457-2700
(618) 457-2700
Mailing address
101 SOUTH GRAHAM AVENUE, CARBONDALE, IL 62901-3001
(618) 457-2700
(618) 457-2700
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03932041
BCBS
—
01
—
045501
HEALTH ALLIANCE
—
01
—
402463
HEALTHLINK
—
01
—
7221104
AETNA
—
Enumeration date
01/10/2006
Last updated
07/08/2007
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