Savanah Kelly

Individual provider Active NPI Behavior Technician · Cedar Glen, CA

NPI 1780439034 · NPPES record last updated Apr 20, 2024

Key facts

NPI
1780439034
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
PO Box 883
Cedar Glen, CA 92321-0883
Phone
(760) 669-6454
NPI assigned
Apr 20, 2024
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

PO Box 883
Cedar Glen, CA 92321-0883

Mailing address

PO Box 883
Cedar Glen, CA 92321-0883
Phone (760) 669-6454

Other providers in Cedar Glen, CA

All providers in Cedar Glen, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.