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Organization

BLUEGRASS ABA OUTPATIENT THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAILYN BAKER (OWNER/MANAGER)
(606) 309-4982
Entity
Organization

Contact information

Practice address
202 W 7TH ST STE 203, LONDON, KY 40741-1763
(606) 309-4982
Mailing address
452 BRANNON MILL RD, LILY, KY 40740-3504

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician

Other

Enumeration date
04/16/2026
Last updated
04/16/2026
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