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Organization

BLUEGRASS CENTER FOR AUTISM

Active
Parent organization
BLUEGRASS CENTER FOR AUTISM
Organization subpart
Yes

Provider details

NPI number
Legal business name
BLUEGRASS CENTER FOR AUTISM
Authorized official
JENNIFER L WILT (DIRECTOR)
(502) 443-3836
Entity
Organization

Contact information

Practice address
9300 CEDAR CENTER WAY STE 200, LOUISVILLE, KY 40291-4522
(502) 473-7219
(502) 709-9892
Mailing address
9300 CEDAR CENTER WAY STE 200, LOUISVILLE, KY 40291-4522
(502) 473-7219
(502) 709-9892

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100700160
KY
Enumeration date
03/13/2025
Last updated
03/13/2025
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