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NPI Code Detail

MEDICARE: SARA KELLY

MEDICARE: SARA KELLY
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 : 1952260556
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA KELLY
Provider Business Mailing Address
First Line : 1305 N COMMERCE DR STE 120
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1305 N COMMERCE DR STE 120
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-5309
Country : US
Telephone Number : 801-557-7657
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ SARA KELLY ” Practice Location

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