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Individual

KALA DABLE MCCLELLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.E., BCBA

Contact information

Practice address
W8057 MAPLE ST, HOLMEN, WI 54636-9500
(612) 978-3190
Mailing address
W8057 MAPLE ST, HOLMEN, WI 54636-9500
(612) 978-3190

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-13672
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-13-13672
BOARD CERTIFIED BEHAVIOR ANALYST
WI
Enumeration date
08/21/2013
Last updated
08/21/2013
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