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General NPI Number Information
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NPI Number | 1134298136
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Entity Type | Organization
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Legal Business Name | TORI KELLEY
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 655 W HIGHWAY 50 STE. 102
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City | CLERMONT
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State | FL
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Zip | 34711-2982
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Country | US
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Telephone | 352-536-2364
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Fax | 352-536-2370
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Provider Business Mailing Address
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Address Line | 655 W HIGHWAY 50 STE. 102
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City | CLERMONT
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State | FL
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Zip | 34711-2982
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Country | US
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Telephone | 352-536-2364
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Fax | 352-536-2370
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | DR. TORI T. KELLEY
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Credential | PH.D.
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Telephone | 352-536-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH7472
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License Number State | FL
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