Individual
SYDNEY LAYNE WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
6435 W HIGHWAY 146, CRESTWOOD, KY 40014-8502
(502) 709-5240
Mailing address
6435 W HIGHWAY 146, CRESTWOOD, KY 40014-8502
(502) 709-5240
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-21-53494
—
103K00000X
Behavior Analyst
Primary
274204
KY
106S00000X
Behavior Technician
RBT-19-80156
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-53494
BCBA CERTIFICATE
—
01
—
RBT-19-80156
RBT
—
Enumeration date
04/23/2019
Last updated
04/19/2023
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