Kettly E Defrant

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-117447 Issued in FL

Practice address

3720 Coconut Creek Pkwy Ste D
Coconut Creek, FL 33066-1634

Phone

(954) 697-0227

NPI assigned

Jun 30, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1265059844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15648 SW 53RD ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274983",
            "telephone_number": "786-556-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 COCONUT CREEK PKWY STE D",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661634",
            "telephone_number": "954-697-0227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15648 SW 53rd St",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330274983",
            "country_code": "US",
            "telephone_number": "786-556-1226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFRANT",
        "first_name": "KETTLY",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-117447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.