| Barbara E Kelly Phd Llc | |
|
100 E Ventris Ave Maitland FL 32751-5626 | |
| (407) 951-8812 | |
| (407) 951-8869 |
| Full Name | Barbara E Kelly Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 100 E Ventris Ave, Maitland, Florida |
| Authorized Official Name and Position | Barbara E. Kelly (MANAGER) |
| Authorized Official Contact | 4079518812 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barbara E Kelly Phd Llc 100 E Ventris Ave Maitland FL 32751-5626 Ph: (407) 951-8812 | Barbara E Kelly Phd Llc 100 E Ventris Ave Maitland FL 32751-5626 Ph: (407) 951-8812 |
| NPI Number | 1457415333 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 07/10/2012 |
| Medicare PECOS PAC ID | 8527069293 |
|---|---|
| Medicare Enrollment ID | O20070123000466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457415333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5762 (Florida) | Primary |
| Provider Name | Barbara E Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851355689 PECOS PAC ID: 2365449782 Enrollment ID: I20061027000285 |
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