Individual
KELLI MARIE BRUINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA, LBA
Contact information
Practice address
125 REARDON BLVD, BARDSTOWN, KY 40004-2034
(502) 507-0933
Mailing address
125 REARDON BLVD, BARDSTOWN, KY 40004-2034
(502) 507-0933
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
251737
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-36182
BCBA CERTIFICATE
—
Enumeration date
06/28/2019
Last updated
11/18/2025
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