MEDICARE: DARIUS 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1558293514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARIUS KELLEY

Provider Business Mailing Address
First Line	:	2405 PALMER CIR STE 100
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6351
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 GLOBAL WAY STE 103
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2265
Country	:	US
Telephone Number	:	443-457-3972
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ DARIUS KELLEY ” Practice Location

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