| Thomas M.l. Kelly, Ed.d., Pa | |
|
625 W College St Suite 109 Grapevine TX 76051-5283 | |
| (817) 481-6951 | |
| Not Available |
| Full Name | Thomas M.l. Kelly, Ed.d., Pa |
|---|---|
| Speciality | Psychologist |
| Location | 625 W College St, Grapevine, Texas |
| Authorized Official Name and Position | Thomas M. L. Kelly (PRESIDENT) |
| Authorized Official Contact | 8174816951 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas M.l. Kelly, Ed.d., Pa 625 W College St Suite 109 Grapevine TX 76051-5283 Ph: (817) 481-6951 | Thomas M.l. Kelly, Ed.d., Pa 625 W College St Suite 109 Grapevine TX 76051-5283 Ph: (817) 481-6951 |
| NPI Number | 1720024532 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720024532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 22126 (Texas) | Primary |
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