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General NPI Number Information
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NPI Number | 1679703581
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Entity Type | Individual
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Provider Name | KELLY C KARL PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 319 LONGWOOD AVE STE 6
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City | BOSTON
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State | MA
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Zip | 02115-5710
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Country | US
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Telephone | 617-232-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 28 SUNSET HILL RD
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City | WEST ROXBURY
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State | MA
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Zip | 02132-7846
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Country | US
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Telephone | 617-596-4185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9031
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License Number State | MA
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