Individual
ALFRED GEORGE KELLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
202 E WASHINGTON ST, SUITE 510, ANN ARBOR, MI 48104-2017
(734) 996-1944
Mailing address
202 E WASHINGTON ST, SUITE 510, ANN ARBOR, MI 48104-2017
(734) 996-1944
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301006080
LICENSE
MI
Enumeration date
12/27/2006
Last updated
02/09/2012
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