| Ellen G Kelman Phd Pc | |
|
10165 N 92nd St 101 Scottsdale AZ 85258-4558 | |
| (480) 451-5558 | |
| (602) 996-6600 |
| Full Name | Ellen G Kelman Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 10165 N 92nd St, Scottsdale, Arizona |
| Authorized Official Name and Position | Ellen G Kelman (OWNER) |
| Authorized Official Contact | 4804515558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen G Kelman Phd Pc 10645 N Tatum Blvd 200-258 Phoenix AZ 85028-3068 Ph: (602) 451-5558 | Ellen G Kelman Phd Pc 10165 N 92nd St 101 Scottsdale AZ 85258-4558 Ph: (480) 451-5558 |
| NPI Number | 1790102630 |
|---|---|
| Provider Enumeration Date | 03/27/2014 |
| Last Update Date | 03/27/2014 |
| Medicare PECOS PAC ID | 5698047983 |
|---|---|
| Medicare Enrollment ID | O20170822001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790102630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3063 (Arizona) | Primary |
| Provider Name | Ellen G Kelman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144244617 PECOS PAC ID: 7012942477 Enrollment ID: I20051004001007 |
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