Staten Michelle Mckellum

NPI #1831917517 in Rockwall, Texas

Provider Information

NPI Number: 1831917517
Entity Type: Individual
Name: Staten Michelle Mckellum
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 1, 2024
Last Updated: Oct 1, 2024

Practice Location

Address: 1100 KINGSTON CT
City: Rockwall
State: Texas
ZIP Code: 75032-8233
Phone: (469) 458-9021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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