Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35SI00429600 | NJ |
Y | 103T00000X | Psychologist | 35SI00429600 | NJ |
NPI | 1013949007 |
---|---|
Provider Name | Dr. Kelly Ann Hargadon |
First Address | Northfield, NJ 08225-1108 |
Second Address | Northfield, NJ 08225-1108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 10/03/2015 |