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NPI Code Detail

MEDICARE: KALLIE IVEY

MEDICARE: KALLIE IVEY
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 : 1891657706
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALLIE IVEY
Provider Business Mailing Address
First Line : 5932 FAIRMONT PKWY STE 120
Second Line :
City : PASADENA
State : TX
Zip : 77505-4020
Country : US
Telephone Number : 855-782-7822
Fax Number :
Provider Business Practice Location Address
First Line : 5932 FAIRMONT PKWY STE 120
Second Line :
City : PASADENA
State : TX
Zip : 77505-4020
Country : US
Telephone Number : 855-782-7822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ KALLIE IVEY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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