Individual
DR. KELLY JEAN MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
30400 TELEGRAPH RD, STE 331, BINGHAM FARMS, MI 48025-4573
(248) 645-5960
Mailing address
800 W LONG LAKE RD, #230, BLOOMFIELD HILLS, MI 48302-2056
(248) 752-7453
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680F389730
BCBS
—
Enumeration date
10/31/2007
Last updated
11/15/2017
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