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NPI Code Detail

MEDICARE: MISS KELLEY SLYNE BCBA

MEDICARE: MISS KELLEY SLYNE 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 Analyst

General Provider Information

NPI Number : 1821792367
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS KELLEY SLYNE BCBA
Provider Business Mailing Address
First Line : 6060 N COLLEGE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-1907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 SPRINGFIELD AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1016
Country : US
Telephone Number : 908-768-2333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2023
Last Update Date : 03/29/2023

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Directions to “ MISS KELLEY SLYNE BCBA” Practice Location

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