Individual
ANGELA DEFEBBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1250 BARDSTOWN RD STE 15, LOUISVILLE, KY 40204-1333
(904) 735-1583
Mailing address
1250 BARDSTOWN RD STE 15, LOUISVILLE, KY 40204-1333
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
KY
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019495300
—
FL
Enumeration date
04/27/2017
Last updated
01/06/2022
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