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NPI Code Detail

MEDICARE: LISA R DELANEY

MEDICARE: LISA R DELANEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst288470KY

General Provider Information

NPI Number : 1235293887
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA R DELANEY
Provider Business Mailing Address
First Line : 6201 BENTON RD
Second Line :
City : PADUCAH
State : KY
Zip : 42003-1304
Country : US
Telephone Number : 270-908-0461
Fax Number : 270-366-0780
Provider Business Practice Location Address
First Line : 6201 BENTON RD
Second Line :
City : PADUCAH
State : KY
Zip : 42003-1304
Country : US
Telephone Number : 270-908-0461
Fax Number : 270-366-0780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 10/20/2023

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Directions to “ LISA R DELANEY ” Practice Location

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