Individual
PRECIOUS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
500 N WALNUT ST APT 4J, EAST ORANGE, NJ 07017-4021
(973) 280-5449
Mailing address
500 N WALNUT ST APT 4J, EAST ORANGE, NJ 07017-4021
(973) 280-5449
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-228703
GA
172A00000X
Driver
—
NJ
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant
—
—
Other
Enumeration date
12/02/2022
Last updated
10/13/2023
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