Individual
ALYSSA IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1609 N DIXIE AVE, ELIZABETHTOWN, KY 42701-6473
(270) 215-5959
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-300980
KY
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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