Individual
AMANDA KYLA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, BCBA
Contact information
Practice address
7775 BAYMEADOWS WAY STE 200, JACKSONVILLE, FL 32256-7531
(904) 831-3974
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
(407) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-19-40066
CO
103K00000X
Behavior Analyst
Primary
1-19-40066
FL
103K00000X
Behavior Analyst
1-19-40066
GA
Other
Enumeration date
01/15/2019
Last updated
10/16/2024
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