Individual
MRS. ALYSSA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACB583876
Contact information
Practice address
706 W PATRICK ST, FREDERICK, MD 21701-4030
(301) 882-7932
Mailing address
10101 TWIN RIVERS RD APT 447, COLUMBIA, MD 21044-6542
(916) 708-6315
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB583876
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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