| Theresa Kellam, Ph.d. | |
|
2201 Dottie Lynn Pkwy Suite 127 Fort Worth TX 76120-4432 | |
| (817) 313-7899 | |
| Not Available |
| Full Name | Theresa Kellam, Ph.d. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2201 Dottie Lynn Pkwy, Fort Worth, Texas |
| Authorized Official Name and Position | Theresa Kellam (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 8173137899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Kellam, Ph.d. 2201 Dottie Lynn Pkwy Suite 127 Fort Worth TX 76120-4432 Ph: (817) 313-7899 | Theresa Kellam, Ph.d. 2201 Dottie Lynn Pkwy Suite 127 Fort Worth TX 76120-4432 Ph: (817) 313-7899 |
| NPI Number | 1205248150 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205248150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 32518 (Texas) | Primary |
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