Individual
JUSTIN MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 843-5300
(270) 843-5383
Mailing address
PO BOX 51322, BOWLING GREEN, KY 42102-5622
(270) 777-9283
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
ABALBA00218345
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
06/30/2014
Last updated
01/21/2016
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