Individual
ANDREW KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2431 CREIGHTON RD, PENSACOLA, FL 32504
(850) 607-6910
(850) 607-6932
Mailing address
3771 STEFANI RD, CANTONMENT, FL 32533-7795
(850) 607-6910
(850) 607-6932
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44790
FL
106E00000X
Assistant Behavior Analyst
0-20-10774
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/09/2018
Last updated
12/18/2020
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