Jaidyn Bow
Individual provider Active NPI Behavior Technician · Vine Grove, KY
NPI 1427839232 · NPPES record last updated Oct 9, 2023
Key facts
- NPI
- 1427839232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-23-301795 (KY)
- Practice address
- 298 Medley CT
Vine Grove, KY 40175-8421 - Phone
- (270) 352-1133
- NPI assigned
- Oct 9, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-301795 | KY | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Early Intervention and Consultation Services, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-301795 | KY | Yes |
Addresses
Primary practice location
298 Medley CT
Vine Grove, KY 40175-8421
Mailing address
298 Medley CT
Vine Grove, KY 40175-8421
Phone (270) 352-1133
Other providers in Vine Grove, KY
- Lisa K Babb
- Michael Anthony Bell
- Christian Michael Bennett
- Thomas R. Bennett
- Jeremy David Bewley
- Victoria Erin Bradley
- Gregory H Brandenburg
- Sarah Renee Calvert
- Melinda Renee Caudill
- Chatterbox Therapy Services
All providers in Vine Grove, KY · Behavior Technician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.