Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | RBT-19-108701 | CO |
NPI | 1003449364 |
---|---|
Provider Name | Kevin Mcelroy |
First Address | Lakewood, CO 80228-6514 |
Second Address | Lakewood, CO 80215-4848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2020 |
Last Update Date | 14/02/2020 |