Individual
KELLIE VALENTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
509 HIDE AWAY LAKE LOOP, KINGSLAND, GA 31548-3248
(386) 473-2815
Mailing address
509 HIDE AWAY LAKE LOOP, KINGSLAND, GA 31548-3248
(386) 473-2815
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-22-233297
GA
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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