Organization
GRACIE BEHAVIOR ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MICHELLE CUNDIFF M.ED., B CBA, LBA (OWNER/CLINICAL DIRECTOR)
(270) 250-5070
Entity
Organization
Contact information
Practice address
203 BURKESVILLE ST STE 101, COLUMBIA, KY 42728-1900
(270) 250-5070
(270) 380-1711
Mailing address
312 HURT ST UNIT C, COLUMBIA, KY 42728-2311
(270) 250-5070
(270) 380-1711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100782180
—
KY
Enumeration date
10/21/2021
Last updated
10/16/2023
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