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Individual

SUZANNE NORTHERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
Mailing address
1150 BREEZY LN, BEREA, KY 40403-8659
(502) 220-1943

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133004432
VA
103K00000X
Behavior Analyst
KY
106S00000X
Behavior Technician

Other

Enumeration date
06/22/2022
Last updated
03/05/2026
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