Theresa Kellam, Ph.d.

NPI 1205248150 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1205248150
Enumeration Date 05/27/2014
Last Updated 05/27/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name THERESA THERESA
Position OWNER/PSYCHOLOGIST
Phone (817) 313-7899
Fax
Practice Location
2201 DOTTIE LYNN PKWY
SUITE 127
FORT WORTH TX, 76120-4432, US
Phone (817) 313-7899
Fax
Business Location
2201 DOTTIE LYNN PKWY
SUITE 127
FORT WORTH TX, 76120-4432, US
Phone (817) 313-7899
Fax
Toxanomy
Taxonomy Code 251S00000X
License State Texas
License Number 32518
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According to our database, Theresa Kellam, Ph.d. NPI is 1205248150, taxonomy code is 251S00000X and license number is 32518, license state is located at Texas. Theresa Kellam, Ph.d. physically located at 2201 Dottie Lynn Pkwy, Fort Worth TX, 76120-4432. NPI Number 1033115704 has the healthcare provider type.

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1205248150 NPI number is provided on an as is basis without warranty of any kind. 1205248150 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Kellam, Ph.d. are for informational purposes only.