Anderson, Tracie

Anderson, Tracie is an individual health care provider with primary practice located at 1519 Baxter Ave , Louisville KY 40205-1008. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Anderson, Tracie can be contacted via phone (502) 409-7181.

Contact Information

Primary practice address
1519 Baxter Ave Louisville KY 40205-1008
Phone: (502) 409-7181
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X ABALBA00222174 Kentucky

Profile Details

NPI number 1407225881
LBN Legal business name Anderson, Tracie
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2015
Last updated Sep 16th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407225881 NPPES
Kentucky Other 1-15-18299 BEHAVIOR ANALYSIS CERTIFICATION BOARD

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