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Individual

KELSEY EDENFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1360 CADUCEUS WAY BLDG. 600 STE 101, WATKINSVILLE, GA 30677-3355
(762) 499-3476
(762) 499-5844
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(407) 915-7729

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-76267
GA
156F00000X
Technician/Technologist
RBT-21-175019
GA

Other

Enumeration date
01/29/2024
Last updated
10/09/2024
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