| NPI | 1306481205 |
|---|---|
| Doing Business As | THERESA KELLAM, PH.D. LICENSED PSYCHOLOGIST |
| Entity Type | Organization |
| Authorized Contact | THERESA KELLAM Owner/Psychologist 817-313-7899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |