Provider Demographics
NPI:1578904140
Name:ABELLA, KEVIN (MA, BCBA)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:ABELLA
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 AEROPLAZA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-4207
Mailing Address - Country:US
Mailing Address - Phone:719-425-7771
Mailing Address - Fax:719-208-7730
Practice Address - Street 1:2005 AEROPLAZA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-4207
Practice Address - Country:US
Practice Address - Phone:719-425-7771
Practice Address - Fax:719-208-7730
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1-13-13629103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst