Provider Demographics
NPI:1780447870
Name:MORRISSEY, KELLIE OLIVIA
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:OLIVIA
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:9860 WESTCLIFF PKWY APT 2022
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6034
Mailing Address - Country:US
Mailing Address - Phone:630-800-0405
Mailing Address - Fax:
Practice Address - Street 1:9860 WESTCLIFF PKWY APT 2022
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-6034
Practice Address - Country:US
Practice Address - Phone:630-800-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst