Provider Demographics
NPI:1760031694
Name:KELLEY, KATHERINE EMILY
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:EMILY
Last Name:KELLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N. ACADEMY AVE
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, GEISINGER MEDICAL CENTER
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822
Mailing Address - Country:US
Mailing Address - Phone:570-271-6516
Mailing Address - Fax:
Practice Address - Street 1:100 N. ACADEMY AVE
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, GEISINGER MEDICAL CENTER
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822
Practice Address - Country:US
Practice Address - Phone:570-271-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist