Individual
MITZI DEANNA KELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2543 ROSS CLARK CIR STE 5, DOTHAN, AL 36301-4916
(334) 699-4007
Mailing address
1213 HOOKS LAKE RD, GADSDEN, AL 35901-2725
(334) 699-4007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT25444164
AL
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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