Provider Demographics
NPI:1447658992
Name:KELLEY, ALISON LAW (BEHAVIOR ANALYST)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LAW
Last Name:KELLEY
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 AVEMORE SQUARE PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7228
Mailing Address - Country:US
Mailing Address - Phone:540-215-0535
Mailing Address - Fax:
Practice Address - Street 1:1112 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4711
Practice Address - Country:US
Practice Address - Phone:540-215-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000290103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst