Provider Demographics
NPI:1538978994
Name:LONDON, KARLEE ELISE (BCBA 1-24-78609)
Entity type:Individual
Prefix:
First Name:KARLEE
Middle Name:ELISE
Last Name:LONDON
Suffix:
Gender:F
Credentials:BCBA 1-24-78609
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 HWY 515 E
Mailing Address - Street 2:UNIT H
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512
Mailing Address - Country:US
Mailing Address - Phone:706-920-0123
Mailing Address - Fax:
Practice Address - Street 1:1847 RIVERSIDE RIDGE DR
Practice Address - Street 2:
Practice Address - City:HIAWASSEE
Practice Address - State:GA
Practice Address - Zip Code:30546-4767
Practice Address - Country:US
Practice Address - Phone:706-920-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-24-78609103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst