Individual
CHRISTOPHER DEREK GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBCBA
Contact information
Practice address
196 OBSERVATION POINTE DR, SOMERSET, KY 42503-3784
(606) 875-2137
Mailing address
196 OBSERVATION POINTE DR, SOMERSET, KY 42503-3784
(606) 875-2137
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0013
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100323050
—
KY
Enumeration date
08/29/2014
Last updated
01/27/2016
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