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General NPI Number Information
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NPI Number | 1235519893
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Entity Type | Individual
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Provider Name | JORDAN ASHLEY YOUNG MS, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 1512 E BRECKINRIDGE ST
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City | LOUISVILLE
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State | KY
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Zip | 40204-1710
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Country | US
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Telephone | 513-604-9957
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Fax |
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Provider Business Mailing Address
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Address Line | 1049 E CALDWELL ST
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City | LOUISVILLE
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State | KY
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Zip | 40204-1857
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Country | US
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Telephone | 513-604-9957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | ABALBA00218868
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License Number State | KY
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