Individual
JERRICCA DARLENE PAIGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2634 NEBLETT AVE, LOUISVILLE, KY 40216-4952
(502) 219-5743
Mailing address
1071 TAMWORTH LN, FRANKFORT, KY 40601-8459
(502) 219-5743
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-256252
KY
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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