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NPI Code Detail

MEDICARE: DR. BARBARA KELLY PHD

MEDICARE: DR. BARBARA KELLY PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist35S100423500NJ
2103T00000XPsychologistPS007682LPA

General Provider Information

NPI Number : 1841410487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARBARA KELLY PHD
Provider Business Mailing Address
First Line : 130 WHITE HORSE PIKE
Second Line :
City : CLEMENTON
State : NJ
Zip : 08021-4159
Country : US
Telephone Number : 856-566-9000
Fax Number : 856-566-9701
Provider Business Practice Location Address
First Line : 130 WHITE HORSE PIKE
Second Line :
City : CLEMENTON
State : NJ
Zip : 08021-4159
Country : US
Telephone Number : 856-566-9000
Fax Number : 856-566-9701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 07/08/2007

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Directions to “ DR. BARBARA KELLY PHD” Practice Location

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