Individual
TIFFANY JOLENE EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1479 FACKLER RD, WEBSTER, KY 40176-7331
(270) 980-1554
Mailing address
1479 FACKLER RD, WEBSTER, KY 40176-7331
(270) 980-1554
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-05250
KY
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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