Individual
JENNIFER K MICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
2034 LANCASHIRE AVE, LOUISVILLE, KY 40205-2954
(502) 500-6608
Mailing address
2304 LANCASHIRE AVE, LOUISVILLE, KY 40205
(502) 500-6608
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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