Individual
MISS BETHANY LYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
355 QUARTERMASTER CT, JEFFERSONVILLE, IN 47130-3670
(812) 258-9802
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-21-55517
IN
103K00000X
Behavior Analyst
Primary
302808
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-55517
BCBA
—
Enumeration date
06/15/2020
Last updated
02/18/2026
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