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NPI Code Detail

MEDICARE: ALEXIS KELLEY RBT

MEDICARE:   ALEXIS  KELLEY  RBT
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 TechnicianRBT-26-542634IN

General Provider Information

NPI Number : 1841124609
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS KELLEY RBT
Provider Business Mailing Address
First Line : 1353 E MAIN ST
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1433
Country : US
Telephone Number : 317-520-4748
Fax Number :
Provider Business Practice Location Address
First Line : 1353 E MAIN ST
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-1433
Country : US
Telephone Number : 317-520-4748
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ ALEXIS KELLEY RBT” Practice Location

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