Individual
KELLIE ANN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(516) 578-2236
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(516) 578-2236
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-32942
CO
Other
Enumeration date
01/10/2019
Last updated
06/26/2024
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