Individual
TYMETHA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1315 9TH AVE, NEPTUNE, NJ 07753-5122
(848) 218-8155
Mailing address
1315 9TH AVE, NEPTUNE, NJ 07753-5122
(848) 218-8155
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NJ
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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