Individual
JONATHAN LUKE WELLINGHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1230 LIBERTY BANK LN STE 330, LOUISVILLE, KY 40222-5756
(150) 279-2926
Mailing address
1230 LIBERTY BANK LN STE 230, LOUISVILLE, KY 40222-5756
(502) 792-9269
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-342088
KY
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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