| Kentuckiana Behavior Therapy Pllc | |
|
5502 Charlestown Pike Jeffersonville IN 47130-8755 | |
| (502) 554-1900 | |
| Not Available |
| Full Name | Kentuckiana Behavior Therapy Pllc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5502 Charlestown Pike, Jeffersonville, Indiana |
| Authorized Official Name and Position | Michael T O'brien (BEHAVIOR ANALYST) |
| Authorized Official Contact | 5025541900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kentuckiana Behavior Therapy Pllc 5502 Charlestown Pike Jeffersonville IN 47130-8755 Ph: () - | Kentuckiana Behavior Therapy Pllc 5502 Charlestown Pike Jeffersonville IN 47130-8755 Ph: (502) 554-1900 |
| NPI Number | 1659881282 |
|---|---|
| Provider Enumeration Date | 10/10/2017 |
| Last Update Date | 10/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659881282 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-16-21910 (Kentucky) | Primary |
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