Provider Demographics
NPI:1669641510
Name:SWEET, KELTON III (BCBA)
Entity Type:Individual
Prefix:MR
First Name:KELTON
Middle Name:
Last Name:SWEET
Suffix:III
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5107 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37914-5176
Mailing Address - Country:US
Mailing Address - Phone:865-809-8210
Mailing Address - Fax:
Practice Address - Street 1:5107 GREEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37914-5176
Practice Address - Country:US
Practice Address - Phone:865-809-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist