Provider Demographics
NPI:1730560350
Name:WARD, KELLEY (MS, BCBA)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:500 FAIRWAY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1814
Mailing Address - Country:US
Mailing Address - Phone:954-693-7885
Mailing Address - Fax:954-342-0273
Practice Address - Street 1:4030 WAKE FOREST RD
Practice Address - Street 2:STE 349
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6800
Practice Address - Country:US
Practice Address - Phone:954-693-7885
Practice Address - Fax:954-342-0273
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst