Individual
STEPHANIE MANECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9900 SHELBYVILLE RD STE 8, LOUISVILLE, KY 40223-2965
(502) 777-8884
Mailing address
9900 SHELBYVILLE RD STE 8, LOUISVILLE, KY 40223-2965
(502) 777-8884
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
00218604
KY
103K00000X
Behavior Analyst
1-15-18570
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100346270
—
KY
Enumeration date
04/14/2015
Last updated
11/02/2022
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