Kynleigh Mari Wendell

Individual provider Active NPI Behavior Technician · Masonic Home, KY

NPI 1700522190 · NPPES record last updated Oct 10, 2023

Key facts

NPI
1700522190
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-22-221657 (KY)
Practice address
3761 Johnson Hall Dr
Masonic Home, KY 40041-9998
Phone
(502) 293-1695
NPI assigned
May 9, 2022
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-22-221657KYMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-22-221657 KY Yes

Addresses

Primary practice location

3761 Johnson Hall Dr
Masonic Home, KY 40041-9998

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007

Other providers in Masonic Home, KY

All providers in Masonic Home, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.