Individual
SAMANTHA KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
146 S THOMAS ST STE C, TUPELO, MS 38801-5328
(662) 840-0974
(662) 840-0388
Mailing address
146 S THOMAS ST STE C, TUPELO, MS 38801-5328
(662) 840-0974
(662) 840-0388
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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