Provider Demographics
NPI:1225885023
Name:KITTO, KELSEA LEIGH (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KELSEA
Middle Name:LEIGH
Last Name:KITTO
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 CENTRAL BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-2818
Mailing Address - Country:US
Mailing Address - Phone:703-496-7804
Mailing Address - Fax:571-359-6784
Practice Address - Street 1:305 HARRISON ST SE STE 1A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3729
Practice Address - Country:US
Practice Address - Phone:703-496-7804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133003553103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst