Alicia Burgess

Individual provider Active NPI Behavior Technician · Brandenburg, KY

NPI 1346893971 · NPPES record last updated Jul 23, 2019

Key facts

NPI
1346893971
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-18-69435
Practice address
51 Summitt Dr
Brandenburg, KY 40108-1435
Phone
(804) 551-1032
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-18-69435 Yes

Addresses

Primary practice location

51 Summitt Dr
Brandenburg, KY 40108-1435

Mailing address

51 Summitt Dr
Brandenburg, KY 40108-1435

Other providers in Brandenburg, KY

All providers in Brandenburg, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.