Individual
SARA M BRECKENRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9943 FOREST GREEN BLVD, LOUISVILLE, KY 40223-5123
(502) 830-9454
Mailing address
3216 BALLARD LN, NEW ALBANY, IN 47150-7200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-224931
KY
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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