Individual
TAYLOR MARIE KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
2904 FOLTZ DR, EDGEWOOD, KY 41017-2525
(859) 795-3000
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-24-77468
—
103K00000X
Behavior Analyst
Primary
296517
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-24-77468
BCBA CERTIFICATE
—
Enumeration date
10/23/2020
Last updated
12/19/2024
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