Provider Demographics
NPI:1891223400
Name:SCHLUETER, KELLE LEIGH (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KELLE
Middle Name:LEIGH
Last Name:SCHLUETER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 HARRISON PLZ
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62305-6106
Mailing Address - Country:US
Mailing Address - Phone:217-316-1218
Mailing Address - Fax:
Practice Address - Street 1:1229 HARRISON PLZ
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-6106
Practice Address - Country:US
Practice Address - Phone:217-316-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016013982103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst