Kelly Gardner

NPI #1144817198 in Putnam, Connecticut

Provider Information

NPI Number: 1144817198
Entity Type: Individual
Name: Kelly Gardner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 23, 2020
Last Updated: Dec 23, 2020

Practice Location

Address: 62 PROVIDENCE PIKE
City: Putnam
State: Connecticut
ZIP Code: 06260-2412
Phone: (818) 241-6780

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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