Individual
KILEY MELLOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
16620 N 40TH ST BLDG C, PHOENIX, AZ 85032-3348
(602) 649-0149
Mailing address
2246 W TONOPAH DR, PHOENIX, AZ 85027-3427
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-533786
AZ
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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