Southern, Kelly

Southern, Kelly is an individual health care provider with primary practice located at 1300 Nw 17Th Ave Ste 272 , Delray Beach FL 33445-2562. She recently has only one registered license in Behavioral Health & Social Service Providers / Assistant Behavior Analyst, which is considered as her primary health care specialty. Southern, Kelly can be contacted via phone (305) 504-9236.

Contact Information

Primary practice address
1300 Nw 17Th Ave Ste 272 Delray Beach FL 33445-2562
Phone: (305) 504-9236
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X

Profile Details

NPI number 1245995422
LBN Legal business name Southern, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2021
Last updated Nov 3rd, 2021 - about 3 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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Identifiers

StateTypeNumberIssuer
All States NPI 1245995422 NPPES
Florida MEDICAID 111703600

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