Most Relevant Information
Provider Data
| NPI Number: | 1003314105 |
| Provider Name: | JILLIAN KELLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 1-17-28092 |
Most Important Dates
| Enumeration Date: | 01/24/2018 |
| Last Updated: | 08/28/2024 |
Provider Practice Location
502 S LUZERNE AVE
BALTIMORE
MD
212243715
Practice Location Phone/Fax
| Phone: | 5083445404 |
| Fax: |
Provider Mailing Location
502 S LUZERNE AVE
BALTIMORE
MD
212243715
Provider Mailing Phone/Fax
| Phone: | 5083445404 |
| Fax: |