Individual
KELLIE BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
11221 N 28TH DR BLDG E, PHOENIX, AZ 85029-5615
(602) 997-2233
Mailing address
3450 N 3RD ST, PHOENIX, AZ 85012-2331
(602) 351-6904
(602) 266-9025
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-000080
AZ
Other
Enumeration date
06/24/2009
Last updated
01/31/2023
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