Individual
DYLAN SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3580 HARGRAVE CT, HEBRON, KY 41048-6900
(859) 317-5985
Mailing address
14 RACE ST, DRY RIDGE, KY 41035-9779
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-215417
KY
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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