MEDICARE: KELWYN HILL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	9114	TX

General Provider Information

NPI Number	:	1033675319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELWYN HILL

Provider Business Mailing Address
First Line	:	4614 CREEKVIEW LN
Second Line	:
City	:	BALCH SPRINGS
State	:	TX
Zip	:	75180-4340
Country	:	US
Telephone Number	:	214-240-8421
Fax Number	:

Provider Business Practice Location Address
First Line	:	4614 CREEKVIEW LN
Second Line	:
City	:	BALCH SPRINGS
State	:	TX
Zip	:	75180-4340
Country	:	US
Telephone Number	:	214-240-8421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	02/18/2026

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Directions to “ KELWYN HILL ” Practice Location

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