Healthcare Provider Details

I. General information

NPI: 1013838432
Provider Name (Legal Business Name): ALLY LEEANN SCARBROUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2614 CHARLESTOWN RD
NEW ALBANY IN
47150
US

IV. Provider business mailing address

2837 SLEVIN ST
LOUISVILLE KY
40212-1942
US

V. Phone/Fax

Practice location:
  • Phone: 930-204-2414
  • Fax:
Mailing address:
  • Phone: 502-708-8143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: