Individual
DR. KEVIN JAMES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
10560 MAIN ST STE 411, FAIRFAX, VA 22030-7174
(703) 855-3802
Mailing address
2251 PIMMIT DR APT 412, FALLS CHURCH, VA 22043-2813
(703) 288-1138
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002204
VA
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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