Individual
SOPHIA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
15 SAUNDERS WAY STE 900, WESTBROOK, ME 04092-4836
(207) 878-9663
Mailing address
15 SAUNDERS WAY STE 900, WESTBROOK, ME 04092-4836
(207) 878-9663
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26596
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-26596
BCBA CERTIFICATION
—
Enumeration date
06/27/2017
Last updated
07/21/2022
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