Individual
KAITLIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2761 JEFFERSON DAVIS HWY STE 107, STAFFORD, VA 22554-8330
(540) 699-3877
Mailing address
21600 OXNARD ST STE 1800, WOODLAND HILLS, CA 91367-7807
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
A67300753
VA
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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