Individual
ALEXIS JORDAN GOETTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5522 TAYLOR MILL RD, TAYLOR MILL, KY 41015-4604
(859) 317-5985
Mailing address
2460 FOUNTAIN PL UNIT A, LAKESIDE PARK, KY 41017-1652
(859) 462-5902
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-68563
KY
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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