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NPI Code Detail

MEDICARE: ROSE MARY RICHARDSON

MEDICARE: ROSE MARY RICHARDSON
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
1103K00000XBehavior Analyst265956KY

General Provider Information

NPI Number : 1518344787
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSE MARY RICHARDSON
Provider Business Mailing Address
First Line : 2464 FORTUNE DR STE 195
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4261
Country : US
Telephone Number : 859-899-9200
Fax Number : 859-899-9202
Provider Business Practice Location Address
First Line : 2464 FORTUNE DR STE 195
Second Line :
City : LEXINGTON
State : KY
Zip : 40509-4261
Country : US
Telephone Number : 859-899-9200
Fax Number : 859-899-9202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2015
Last Update Date : 06/02/2026

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Directions to “ ROSE MARY RICHARDSON ” Practice Location

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