Healthcare Provider Details

I. General information

NPI: 1942890348
Provider Name (Legal Business Name): AMANDA KING BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 ALLEN ST
OWENSBORO KY
42303-3437
US

IV. Provider business mailing address

445 MAIN ST APT 2
SACRAMENTO KY
42372-8401
US

V. Phone/Fax

Practice location:
  • Phone: 270-240-1842
  • Fax:
Mailing address:
  • Phone: 270-589-9426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number292400
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-146890
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: