Individual
BETHANY MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 N DIXIE AVE STE 114, ELIZABETHTOWN, KY 42701-7494
(270) 702-4641
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(615) 361-4000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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