Individual
AMBER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1855 W HIBISCUS BLVD, MELBOURNE, FL 32901-2622
(321) 265-4409
Mailing address
1855 W HIBISCUS BLVD, MELBOURNE, FL 32901-2622
(321) 265-4409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1735140
FL
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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