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Individual

KYLE A STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAE, BCBA, LBA

Contact information

Practice address
320 MAIN ST, SHELBYVILLE, KY 40065-1026
(502) 633-1315
(502) 633-1316
Mailing address
PO BOX 516, SHELBYVILLE, KY 40066-0516
(502) 633-1315
(502) 633-1316

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100250830
KY
Enumeration date
05/01/2012
Last updated
01/21/2014
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