Kelley, Shannon Marie

Kelley, Shannon Marie is an individual health care provider with primary practice located at 10530 Warwick Ave Suite C5, Fairfax VA 22030-3132. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Kelley, Shannon Marie can be contacted via phone (703) 216-9230.

Contact Information

Primary practice address
10530 Warwick Ave Suite C5 Fairfax VA 22030-3132
Phone: (703) 216-9230
Fax: (571) 384-5815
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-11-9387 Virginia

Profile Details

NPI number 1700153327
LBN Legal business name Kelley, Shannon Marie
Credentials M.ED, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2011
Last updated Sep 12th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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