MEDICARE: KELSEY FAYE TEMPLE 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
1	103K00000X	Behavior Analyst	2026-007	AL

General Provider Information

NPI Number	:	1437991270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY FAYE TEMPLE BCBA

Provider Business Mailing Address
First Line	:	10063 ROCKWELL SCHOOL DR STE D
Second Line	:
City	:	SPANISH FORT
State	:	AL
Zip	:	36527-8511
Country	:	US
Telephone Number	:	251-210-8200
Fax Number	:	251-249-9942

Provider Business Practice Location Address
First Line	:	10063 ROCKWELL SCHOOL DR STE D
Second Line	:
City	:	SPANISH FORT
State	:	AL
Zip	:	36527-8511
Country	:	US
Telephone Number	:	251-210-8200
Fax Number	:	251-249-9942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	03/09/2026

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