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Individual

MRS. KELLY ROBBEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
9917 W ANTIETAM ST, BOISE, ID 83709-3405
(850) 797-8280
Mailing address
80 COLLEGE BLVD E, NICEVILLE, FL 32578-1343
(850) 279-3000
(850) 389-2269

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27016
106E00000X
Assistant Behavior Analyst
0177958
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-17-27016
BACB
Enumeration date
06/26/2017
Last updated
03/06/2023
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