Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1004 | KY |
NPI | 1013348671 |
---|---|
Provider Name | Erica C Conley |
First Address | Henderson, KY 42419-0066 |
Second Address | Henderson, KY 42420-3231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2013 |
Last Update Date | 07/06/2020 |