Individual
JAMIE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
635 S MAIN ST STE B, LEITCHFIELD, KY 42754-1056
(270) 287-0656
(270) 230-0328
Mailing address
635 S MAIN ST STE B, LEITCHFIELD, KY 42754-1056
(270) 287-0656
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-123163
RBT
KY
Enumeration date
06/15/2020
Last updated
06/15/2020
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