Individual
KEATHER KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
180 ROBERT CURRY DR, MARTINSVILLE, IN 46151-8076
(463) 201-6463
(314) 245-3401
Mailing address
1375 E MORGAN ST., MARTINSVILLE, IN 46151
(317) 842-5911
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012222
—
IN
Enumeration date
03/02/2011
Last updated
10/06/2021
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