Individual
MR. MATTHEW GEORGE BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
25 BEECH DR, EDGEWOOD, KY 41017-2302
(502) 689-8147
Mailing address
25 BEECH DR, EDGEWOOD, KY 41017-2302
(502) 689-8147
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
00981
OH
103K00000X
Behavior Analyst
Primary
268643
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00981
CERTIFIED OHIO BEHAVIOR ANALYST (COBA)
—
01
—
268643
LICENSED BEHAVIOR ANALYST (KY)
KY
Enumeration date
01/12/2022
Last updated
03/28/2022
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