Organization
EASTERN KENTUCKY ABA SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI RAYBURN-DEHART BCBA, LBA, M.ED (EXECUTIVE DIRECTOR)
(606) 465-0786
Entity
Organization
Contact information
Practice address
2995 BIG PERRY RD, MOREHEAD, KY 40351-8156
(606) 465-0786
Mailing address
2995 BIG PERRY RD, MOREHEAD, KY 40351-8156
(606) 465-0786
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168533
LICENSED BEHAVIOR ANALYST
KY
05
—
7100415390
—
KY
Enumeration date
06/04/2019
Last updated
06/20/2023
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