Healthcare Provider Details

I. General information

NPI: 1316861701
Provider Name (Legal Business Name): KELLY FON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 SPRING ST STE 101
SILVER SPRING MD
20910-2756
US

IV. Provider business mailing address

9090 PINEY BRANCH RD APT 101
SILVER SPRING MD
20903-2741
US

V. Phone/Fax

Practice location:
  • Phone: 240-398-3514
  • Fax:
Mailing address:
  • Phone: 240-688-6785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: