Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PS015379 | PA |
N | 103T00000X | Psychologist | PS015379 | PA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | B10000878 | DE |
NPI | 1093838997 |
---|---|
Provider Name | Dr. Karen P Kelly |
First Address | Rockland, DE 19723-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2007 |
Last Update Date | 11/08/2011 |