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General NPI Number Information
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NPI Number | 1538678917
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Entity Type | Organization
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Legal Business Name | KELLY NEWBY, PSY.D., PLLC
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 2450 W RIDGE RD STE 303
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City | ROCHESTER
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State | NY
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Zip | 14626-3037
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Country | US
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Telephone | 585-448-0936
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Fax | 585-448-0973
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Provider Business Mailing Address
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Address Line | 2450 W RIDGE RD STE 303
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City | ROCHESTER
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State | NY
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Zip | 14626-3037
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Country | US
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Telephone | 585-448-0936
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Fax | 585-448-0973
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Authorized Official
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Title or Position | OWNER
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Name | KELLY NEWBY
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Credential |
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Telephone | 585-448-0936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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