Organization
TO THE MAX BEHAVIOR THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISA F HARPER (ADMIN ASST)
(270) 316-3487
Entity
Organization
Contact information
Practice address
4225 BENTTREE DR, OWENSBORO, KY 42301-8669
(270) 240-2846
(270) 246-9762
Mailing address
4225 BENTTREE DR, OWENSBORO, KY 42301-8669
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100461110
—
KY
Enumeration date
01/31/2022
Last updated
01/31/2022
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