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General NPI Number Information
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NPI Number | 1538628755
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Entity Type | Individual
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Provider Name | ARIEL E KELLAM M.ED., BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 110 SW THOMAS ST
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City | BURLESON
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State | TX
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Zip | 76028-3818
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Country | US
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Telephone | 682-200-3965
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Fax | 682-334-7430
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Provider Business Mailing Address
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Address Line | 3305 OLYMPIA FIELDS DR
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City | BURLESON
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State | TX
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Zip | 76028-3692
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Country | US
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Telephone | 714-366-9444
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Fax | 682-334-7430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 5633
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License Number State | TX
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