Individual
JODECI THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 LIBERTY BANK LN STE 330, LOUISVILLE, KY 40222-5756
(502) 792-9269
Mailing address
9003 RED DEER CIR, LOUISVILLE, KY 40220-6736
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-225637
KY
Other
Enumeration date
04/21/2023
Last updated
04/21/2023
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