Individual
KEVIN SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
535 RIVERSTONE PKWY STE 101, CANTON, GA 30114-2566
(470) 863-3090
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(407) 807-7798
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
07/16/2025
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