Provider Demographics
NPI:1629572003
Name:KILEY, ALISON CATHERINE (RBT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:CATHERINE
Last Name:KILEY
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 1:11408 WHITE BAY LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-2410
Mailing Address - Country:US
Mailing Address - Phone:904-608-8116
Mailing Address - Fax:
Practice Address - Street 1:11408 WHITE BAY LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-2410
Practice Address - Country:US
Practice Address - Phone:904-608-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-08286103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst