Individual
MR. ANDREW COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1035 STRADER DR STE 150, LEXINGTON, KY 40505-4090
(859) 899-9200
Mailing address
1035 STRADER DR STE 150, LEXINGTON, KY 40505-4090
(859) 899-9200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-98193
KY
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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