Individual
DR. JENNIFER ELISABET KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
833 SW 11TH AVE, STE 245, PORTLAND, OR 97205-2132
(971) 248-5050
Mailing address
833 SW 11TH AVE, STE 245, PORTLAND, OR 97205-2132
(971) 248-5050
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
10/17/2011
Last updated
05/23/2017
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