Provider Demographics
NPI:1497337604
Name:ZIRCHER, KELSEY (RBT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:ZIRCHER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 FISHBURG RD
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5306
Mailing Address - Country:US
Mailing Address - Phone:937-723-8272
Mailing Address - Fax:937-723-8223
Practice Address - Street 1:4925 FISHBURG RD
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-5306
Practice Address - Country:US
Practice Address - Phone:937-723-8272
Practice Address - Fax:937-723-8223
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-21-164618106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician