Individual
BRETT BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1460 CAYTON RD, FLORENCE, KY 41042-9358
(859) 620-0041
Mailing address
1460 CAYTON RD, FLORENCE, KY 41042-9358
(859) 620-0041
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22930
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
07/27/2016
Last updated
02/22/2022
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