Provider Demographics
NPI:1255935698
Name:AICHER, KELLY ANN (BCBA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:AICHER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:ANN
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:1509 E COLONIAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4729
Mailing Address - Country:US
Mailing Address - Phone:407-218-4340
Mailing Address - Fax:407-218-4303
Practice Address - Street 1:758 N SUN DR STE 112
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2599
Practice Address - Country:US
Practice Address - Phone:407-317-5429
Practice Address - Fax:321-800-7201
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-119819106S00000X
FL1-21-53616103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108843600Medicaid