Individual
KELSEY LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
10930 W POTTER RD STE A, WAUWATOSA, WI 53226-3450
(262) 200-0900
Mailing address
1436 E SAVELAND AVE, MILWAUKEE, WI 53207-4078
(262) 339-8433
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-47876
BEHAVIOR ANALYST CERTIFICATION BOARD
—
Enumeration date
04/12/2021
Last updated
04/12/2021
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