| NPI | 1316350457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER WHOBREY Provider Enrollment 502-630-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2020-12-17 |