Individual
MEGAN BREANNA WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RBT, BCBA
Contact information
Practice address
105 WINDSOR PATH STE 1, GEORGETOWN, KY 40324-9819
(859) 317-5985
Mailing address
133 BERKSHIRE LN, GEORGETOWN, KY 40324-8818
(606) 471-8126
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-20-148476
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-23-65710
BCBA CERT NUMBER
—
01
—
RBT-20-148476
RBT CERT NUMBER
—
Enumeration date
06/04/2019
Last updated
07/25/2023
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