Individual
JUDITH LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
227 W GRIMES LN, BLOOMINGTON, IN 47403-3015
(812) 322-0313
Mailing address
PO BOX 668, BLOOMINGTON, IN 47402-0668
(812) 322-0313
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69259
IN
106S00000X
Behavior Technician
RBT-16-15335
IN
Other
Enumeration date
07/01/2019
Last updated
11/20/2023
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