Individual
JILLIAN GULLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 LIBERTY BANK LN STE 230, LOUISVILLE, KY 40222-5756
(502) 792-9269
(502) 792-9269
Mailing address
7755 BROOKVIEW DR APT 11, LOUISVILLE, KY 40214-3962
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-1197388
KY
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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