Individual
JEANNIE KELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2815 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-3960
(270) 202-3725
Mailing address
699 NORTHRIDGE DR, BOWLING GREEN, KY 42101-6590
(270) 202-3725
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
297971
KY
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
05/18/2011
Last updated
06/27/2025
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