Individual
MIKIA DESHEA COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
261 RUCCIO WAY STE 190, LEXINGTON, KY 40503-3566
(859) 279-0252
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
(502) 233-9074
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1296313
KY
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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