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Individual

ISAIAH HOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RBT

Contact information

Practice address
822 WOODWAY ST, BOWLING GREEN, KY 42101-2771
(270) 901-5000
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
292333
KY
106S00000X
Behavior Technician
RBT-21-173239
KY

Other

Enumeration date
06/24/2021
Last updated
06/04/2024
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