Individual
MARTHA GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
527 E MAPLE ST, CANEYVILLE, KY 42721-9060
(270) 230-7738
Mailing address
527 E MAPLE ST, CANEYVILLE, KY 42721-9060
(270) 230-7738
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
296863
KY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/22/2017
Last updated
05/27/2025
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