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Contact Information

KELLY M CHAMPION, PhD
4820 MORTENSEN ROAD
SUITE 102
AMES, IA50014-5531
 Phone: 781-552-6500
 Fax: 888-859-4941
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KELLY M CHAMPION · (Female)

NPI Number 1538354998
Status Active
Credentials PhD
Entity Individual
Enumeration date 09/10/2007
Last updated 05/28/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • IA License # 07388
  • MA License # 8774
  • Other $$$$$$$$$ SOCIAL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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