DR. Mary Alston Kerllenevich, PH.D.

NPI #1386713048 in St Augustine, Florida

Provider Information

NPI Number: 1386713048
Entity Type: Individual
Name: DR. Mary Alston Kerllenevich, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: PH.D.
Enumeration Date: Nov 7, 2006
Last Updated: Aug 12, 2008

Practice Location

Address: 1100 S PONCE DE LEON BLVD STE 1
City: St Augustine
State: Florida
ZIP Code: 32084-6013
Phone: (904) 824-7733

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary
Psychologist - Clinical — Clinical	103TC0700X

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