Individual
SARAH KENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2545 FOX POINTE DR, COLUMBUS, IN 47203-3220
(812) 657-3575
Mailing address
1009 W 1ST ST, BLOOMINGTON, IN 47403-2207
(317) 417-9027
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29217
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300013371
—
IN
Enumeration date
04/03/2018
Last updated
06/07/2019
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