Individual
RILEY JO COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 GENE CASH RD, CAMPBELLSVILLE, KY 42718-4908
(270) 465-7768
Mailing address
1877 HIGHWAY 768 RD E, COLUMBIA, KY 42728-7834
(270) 634-3318
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB887113
KY
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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