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NPI Code Detail

MEDICARE: KELLI COLE BCBA

MEDICARE: KELLI COLE 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 Analyst1-18-34266TX

General Provider Information

NPI Number : 1164986030
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI COLE BCBA
Provider Business Mailing Address
First Line : 6914 BRISBANE CT STE 200
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-4924
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12711 TELGE RD STE 400
Second Line :
City : CYPRESS
State : TX
Zip : 77429-1938
Country : US
Telephone Number : 713-997-9645
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2019
Last Update Date : 07/17/2023

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Directions to “ KELLI COLE BCBA” Practice Location

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