Individual
MICHAEL O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
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
170612
KY
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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