Individual
AMYEE GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS BCBA LBA
Contact information
Practice address
6435 W HIGHWAY 146, CRESTWOOD, KY 40014-8502
(502) 709-5240
(855) 632-0826
Mailing address
6435 W HIGHWAY 146, CRESTWOOD, KY 40014-8502
(502) 709-5240
(855) 632-0826
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB451953
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275171662
TRICARE
TX
01
—
RBT-18-65004
RBT CERTIFICATE
—
Enumeration date
04/08/2019
Last updated
10/16/2023
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