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Individual

JASON NEEL SIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
800 W WOODLAWN AVE, LOUISVILLE, KY 40215-2472
(502) 409-7181
(888) 450-0935
Mailing address
1601 ROSEWOOD AVE, LOUISVILLE, KY 40204-1327
(210) 865-7734
(888) 450-0935

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-02-0855
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100337780
KY
Enumeration date
12/02/2009
Last updated
10/28/2016
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