Kelly, Theresa Ann

Kelly, Theresa Ann is an sole proprietor health care provider with primary practice located at 2401 W Main St , Marion IL 62959-1188. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kelly, Theresa Ann can be contacted via phone (618) 997-5311.

Contact Information

Primary practice address
2401 W Main St Marion IL 62959-1188
Phone: (618) 997-5311
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 071-006782 Illinois

Profile Details

NPI number 1477663763
LBN Legal business name Kelly, Theresa Ann
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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