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General NPI Number Information
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NPI Number | 1801367784
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Entity Type | Individual
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Provider Name | KELSEY FORIER
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Gender | Female
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 2510 W IRVING PARK RD UNIT 406
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City | CHICAGO
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State | IL
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Zip | 60618-3749
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Country | US
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Telephone | 847-843-6239
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Fax |
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Provider Business Mailing Address
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Address Line | 7634 W BALMORAL AVE
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City | CHICAGO
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State | IL
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Zip | 60656-1724
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Country | US
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Telephone |
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Fax |
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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 | 1-18-31091
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License Number State | IL
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