Individual
STEPHANIE HOUSEHOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4044 FORT CAMPBELL BLVD STE 604, HOPKINSVILLE, KY 42240
(877) 315-8080
(877) 345-4009
Mailing address
373 S. WILLOW STREET, SUITE 266, MANCHESTER, NH 03103-5751
(877) 315-8080
(877) 345-4009
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41174
KY
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/21/2018
Last updated
05/24/2021
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