Individual
MS. AMY JO BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
925 DUDLEY PIKE, EDGEWOOD, KY 41017-8120
(859) 360-3006
(859) 360-3053
Mailing address
925 DUDLEY PIKE, EDGEWOOD, KY 41017-8120
(859) 360-3006
(859) 360-3053
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34840
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952840860
—
KY
Enumeration date
09/10/2019
Last updated
09/10/2019
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