Individual
KELLI ANN LAURICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 ELMWOOD TER, WEST CALDWELL, NJ 07006-7713
(973) 766-4969
Mailing address
17 ELMWOOD TER, WEST CALDWELL, NJ 07006-7713
(973) 766-4969
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52340
NJ
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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