Most Relevant Information
Provider Data
| NPI Number: | 1003662552 |
| Provider Name: | KELLY LORD |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/25/2024 |
| Last Updated: | 04/25/2024 |
Provider Practice Location
1319 W MAY ST
WICHITA
KS
672133505
Practice Location Phone/Fax
| Phone: | 3162237159 |
| Fax: |
Provider Mailing Location
1319 W MAY ST
WICHITA
KS
672133505
Provider Mailing Phone/Fax
| Phone: | 3162237159 |
| Fax: |