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NPI Code Detail

MEDICARE: DANNAH KELLEY

MEDICARE: DANNAH KELLEY
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1457918534
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANNAH KELLEY
Provider Business Mailing Address
First Line : 1301 E ORANGEWOOD AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-6807
Country : US
Telephone Number : 800-249-1266
Fax Number :
Provider Business Practice Location Address
First Line : 1455 NW IRVING ST STE 200
Second Line :
City : PORTLAND
State : OR
Zip : 97209-2275
Country : US
Telephone Number : 800-249-1266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2019
Last Update Date : 05/23/2019

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Directions to “ DANNAH KELLEY ” Practice Location

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