Individual
SISMAI MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 W 12TH AVE, BOWLING GREEN, KY 42101-2083
(270) 936-7472
Mailing address
19 W 12TH AVE, BOWLING GREEN, KY 42101-2083
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-26-545421
KY
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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