Individual
JEREMY MICHAEL EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. BCBA, LBA
Contact information
Practice address
165 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7940
(270) 715-8453
Mailing address
165 NATCHEZ TRACE AVE, BOWLING GREEN, KY 42103-7940
(270) 715-8453
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
307199
KY
106S00000X
Behavior Technician
Primary
RBT-19-77758
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-26-88034
BACB
KY
01
—
RBT-19-77758
RBT CERTIFICATE
—
Enumeration date
04/05/2019
Last updated
03/30/2026
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