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Individual

MRS. MONICA BURTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
67 JACKS LN, SOMERSET, KY 42501-6152
(606) 425-4371
(606) 699-1669
Mailing address
38 MITCHELL LN, SOMERSET, KY 42503-6395

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
240776
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-18-29702
BACB
01
14609077
CAQH
01
240776
COMMONWEALTH OF KENTUCKY
KY
05
7100590440
KY
Enumeration date
03/13/2019
Last updated
01/08/2021
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