Individual
BRANDON BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
635 S MAIN ST, LEITCHFIELD, KY 42754-1056
(270) 352-1133
Mailing address
105 MADELYN DR, LEITCHFIELD, KY 42754-3015
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-92006
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RBT-19-92006
—
KY
Enumeration date
07/11/2019
Last updated
07/11/2019
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