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General NPI Number Information
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NPI Number | 1750802161
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Entity Type | Organization
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Legal Business Name | ENRICH EDUCATIONAL & BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1709 BONNYCASTLE AVE
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City | LOUISVILLE
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State | KY
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Zip | 40205-1014
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Country | US
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Telephone | 615-480-9057
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 BONNYCASTLE AVE
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City | LOUISVILLE
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State | KY
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Zip | 40205-1014
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Country | US
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Telephone | 615-480-9057
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA SUZANNE BIRKHEAD
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Credential | LBA, BCBA
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Telephone | 615-480-9057
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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 | 167319
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License Number State | KY
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