Individual
LEANN NICOLE MATHENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
363 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160
(270) 352-1133
Mailing address
464 SPRINGFIELD RD APT 2A, ELIZABETHTOWN, KY 42701-6864
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-61984
KY
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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