Frederick, Kelly K

Frederick, Kelly K is an individual health care provider with primary practice located at 1063 E 900 S , Warren IN 46792-9214. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / School is her primary health care specialty. Frederick, Kelly K can be contacted via phone (260) 468-3093.

Contact Information

Primary practice address
1063 E 900 S Warren IN 46792-9214
Phone: (260) 468-3093
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 10267664 Indiana
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-19-78150 Indiana

Profile Details

NPI number 1821652876
LBN Legal business name Frederick, Kelly K
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2019
Last updated Aug 19th, 2021 - about 5 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 1821652876 NPPES
Indiana Other 10267664 INDIANA DEPARTMENT OF EDUCATION

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