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NPI Code Detail

MEDICARE: KAYLI ELYSE PLEDGER BCBA

MEDICARE:   KAYLI ELYSE PLEDGER  BCBA
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
1103K00000XBehavior Analyst1-19-37706

General Provider Information

NPI Number : 1043793573
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLI ELYSE PLEDGER BCBA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number : 407-588-6294
Provider Business Practice Location Address
First Line : 137 JOHNSON FERRY RD STE 2170
Second Line :
City : MARIETTA
State : GA
Zip : 30068-4948
Country : US
Telephone Number : 470-648-0510
Fax Number : 470-317-2127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 04/28/2022

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Directions to “ KAYLI ELYSE PLEDGER BCBA” Practice Location

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