Individual
LEE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1405 E BURNETT AVE, LOUISVILLE, KY 40217-1577
(502) 852-4631
Mailing address
1405 E BURNETT AVE, LOUISVILLE, KY 40217-1577
(502) 852-4631
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
383640
KY
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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