Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 103K00000X | Behavior Analyst | 273868 | KY |
NPI | 1003389933 |
---|---|
Provider Name | Megan Conn |
First Address | Ashland, KY 41105-0790 |
Second Address | West Liberty, KY 41472-1019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2019 |
Last Update Date | 10/01/2022 |