Individual
KELSEY TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 ALDERSGATE RD, LITTLE ROCK, AR 72205-6675
(501) 574-3053
Mailing address
1701 ALDERSGATE RD, LITTLE ROCK, AR 72205-6675
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/13/2020
Last updated
08/09/2021
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