Individual
DR. LAURA J.S. KELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7 4TH ST, SUITES 32 AND 33, PETALUMA, CA 94952-3043
(707) 364-9388
Mailing address
7 4TH ST, SUITES 32 AND 33, PETALUMA, CA 94952-3043
(707) 364-9388
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY19863
CA
Other
Enumeration date
01/25/2007
Last updated
01/31/2013
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