Individual
BARRY SHANE KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 E 15TH ST STE 800B, EDMOND, OK 73013-6682
(405) 455-6868
(405) 562-3444
Mailing address
1900 E 15TH ST STE 800B, EDMOND, OK 73013-6682
(405) 455-6868
(405) 562-3444
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-63651
FL
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/31/2021
Last updated
11/10/2023
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