Individual
MS. KELLI KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1353 E MAIN ST, BROWNSBURG, IN 46112-1433
(317) 520-4748
(888) 498-5529
Mailing address
4400 E EVANS AVE, DENVER, CO 80222-5023
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12043059
CO
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300049688
—
IN
Enumeration date
03/13/2018
Last updated
08/22/2022
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