Individual
DERIC ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCABA
Contact information
Practice address
105 MESQUITE LN, NICHOLASVILLE, KY 40356-9519
(859) 576-4178
Mailing address
105 MESQUITE LN, NICHOLASVILLE, KY 40356-9519
(859) 576-4178
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-17-7944
KY
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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