Provider Demographics
NPI:1215021811
Name:GARIGLIETTI, KELLI P (PHD)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:P
Last Name:GARIGLIETTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1266
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762
Mailing Address - Country:US
Mailing Address - Phone:620-232-0273
Mailing Address - Fax:620-231-0081
Practice Address - Street 1:200 E CENTENNIAL
Practice Address - Street 2:SUITE 13
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762
Practice Address - Country:US
Practice Address - Phone:620-232-0273
Practice Address - Fax:620-231-0081
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1153103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS119709Medicare ID - Type Unspecified
P50025Medicare UPIN