Provider Demographics
NPI:1285164475
Name:KELTING, DEVON LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEVON
Middle Name:LEE
Last Name:KELTING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9739
Mailing Address - Country:US
Mailing Address - Phone:413-320-3142
Mailing Address - Fax:
Practice Address - Street 1:79 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9739
Practice Address - Country:US
Practice Address - Phone:413-320-3142
Practice Address - Fax:413-320-3142
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty