Kelsi Elizabeth Wade, M.ED, BCBA, LBA
Individual provider Active NPI Behavior Analyst · MC Gregor, TX
NPI 1083304265 · NPPES record last updated May 10, 2023
Key facts
- NPI
- 1083304265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-21-57101 (TX)
- Practice address
- 304 S Adams St
MC Gregor, TX 76657-2300 - Phone
- (254) 644-1449
- NPI assigned
- May 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-57101 | TX | Yes |
Addresses
Primary practice location
304 S Adams St
MC Gregor, TX 76657-2300
Mailing address
304 S Adams St
MC Gregor, TX 76657-2300
Phone (254) 644-1449
Other providers in MC Gregor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.