Organization
KENTUCKIANA BEHAVIOR THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL T O'BRIEN (BEHAVIOR ANALYST)
(502) 554-1900
Entity
Organization
Contact information
Practice address
5502 CHARLESTOWN PIKE, JEFFERSONVILLE, IN 47130-8755
(502) 554-1900
Mailing address
5502 CHARLESTOWN PIKE, JEFFERSONVILLE, IN 47130-8755
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-21910
KY
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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