Individual
AVERY HAZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1169 EASTERN PKWY STE G1111, LOUISVILLE, KY 40217-1462
(502) 242-9091
Mailing address
1169 EASTERN PKWY STE G1111, LOUISVILLE, KY 40217-1462
(502) 242-9091
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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