Individual
AUTUMN STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
106 S MAIN ST, DRY RIDGE, KY 41035-9406
(877) 498-0319
Mailing address
106 S MAIN ST, DRY RIDGE, KY 41035-9406
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-397873
KY
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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