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Individual

MINDY MICHELLE TANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
90 HOWARD DR, SHELBYVILLE, KY 40065
(502) 633-1007
(502) 437-0624
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 633-1007
(502) 437-0624

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
243193
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-13-12752
BCBA
IN
Enumeration date
06/24/2014
Last updated
03/06/2019
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