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Organization

FARM CREEK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE KELLS BCBA (OWNER)
(831) 334-0248
Entity
Organization

Contact information

Practice address
190 CHERRY HILL DR APT SUITE, STAFFORD, VA 22556-3654
(831) 334-0248
Mailing address
190 CHERRY HILL DR APT SUITE, STAFFORD, VA 22556-3654
(831) 334-0248

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1275900383
VA
Enumeration date
09/12/2022
Last updated
09/12/2022
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