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1164542585
KELLI M BISHOP
IDAHO FALLS, ID
NPI
1164542585
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist Clinical
(Licence: ID PSY-202640)
Enumeration Date
2007-03-30
Last Update Date
2016-07-25
Business Address
DR. KELLI M BISHOP PSY.D.
111 E 16TH ST
IDAHO FALLS, ID 83404-5919
Phone number: 208-523-1130
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Mailing Address
DR. KELLI M BISHOP PSY.D.
4255 WADE GREEN RD NW STE 414
KENNESAW, GA 30144-1763
Phone number: 678-213-2194
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