Jackson Cole Kelly

NPI #1588349740 in Des Plaines, Illinois

Provider Information

NPI Number: 1588349740
Entity Type: Individual
Name: Jackson Cole Kelly
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jun 15, 2023
Last Updated: Jun 15, 2023

Practice Location

Address: 950 LEE ST STE 210
City: Des Plaines
State: Illinois
ZIP Code: 60016-6574
Phone: (877) 486-4140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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