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Tyshan Kelley

Behavior Technician in Omaha, NE. Individual provider (NPI-1).

NPI number1104724327
StatusActive
Last updated in NPPESOct 28, 2026

Details

NPI
1104724327
Entity type
Individual (NPI-1)
Name
Tyshan Kelley
Sex
Male
Sole proprietor
No
Enumeration date
Oct 28, 2026
Certification date
Oct 28, 2026
Last updated
Oct 28, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

9802 Nicholas St Ste 395
Omaha, NE 68114-2168

Phone 402-252-1363

Mailing address

185 Route 70 Ste 302
Toms River, NJ 08755-0911

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