| T. K. Kelso, Psy.d, Llc | |
|
420 Boulevard, Suite 208 Mountain Lakes NJ 07046-1742 | |
| (973) 299-2888 | |
| (973) 299-2876 |
| Full Name | T. K. Kelso, Psy.d, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 420 Boulevard, Suite 208, Mountain Lakes, New Jersey |
| Authorized Official Name and Position | Theresa K Kelso (OWNER) |
| Authorized Official Contact | 9732992888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T. K. Kelso, Psy.d, Llc 420 Boulevard, Suite 208 Mountain Lakes NJ 07046-1742 Ph: (973) 299-2888 | T. K. Kelso, Psy.d, Llc 420 Boulevard, Suite 208 Mountain Lakes NJ 07046-1742 Ph: (973) 299-2888 |
| NPI Number | 1033369699 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 12/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033369699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 35S1002377 (New Jersey) | Primary |
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