KELLY PHAN

NEWARK, CA
NPI1407609654
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy106S00000X Behavior Technician
(Licence: CA  46-1305562)
Enumeration Date2024-04-08
Last Update Date2026-09-23
Business Address
KELLY PHAN
39899 BALENTINE DR STE 110
NEWARK, CA 94560-5356
Phone number: 510-244-1145
Mailing Address
KELLY PHAN
PO BOX 740780
ATLANTA, GA 30374-0780
Phone number: 855-223-7123
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