Individual
JEROMY KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6210 BASELINE RD, LITTLE ROCK, AR 72209-4728
(501) 265-0302
Mailing address
6210 BASELINE RD, LITTLE ROCK, AR 72209-4728
(501) 265-0302
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-437496
AR
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
Other
Enumeration date
07/25/2025
Last updated
04/09/2026
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