Organization
CLINICAL BEHAVIOR ANALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JONES (QUALITY SYSTEM SPECIALIST)
(502) 409-7181
Entity
Organization
Contact information
Practice address
1601 ROSEWOOD AVE, LOUISVILLE, KY 40204-1327
(502) 409-7181
Mailing address
800 W WOODLAWN AVE, LOUISVILLE, KY 40215-2472
(502) 409-7181
(888) 450-0935
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
167209
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100343010
—
KY
Enumeration date
08/16/2016
Last updated
08/16/2016
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