Individual
KELLY WILLARD PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2580 17TH ST UNIT 211, DENVER, CO 80211-6411
(650) 799-3931
Mailing address
2580 17TH ST UNIT 211, DENVER, CO 80211-6411
(650) 799-3931
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB454147
TN
Other
Enumeration date
11/21/2021
Last updated
05/30/2025
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