NPI 1003581810

Blaire Kidwell, RBT

Practitioner Behavior Technician Louisville, KY

Practice location

Address: 215 S Hurstbourne Pkwy STE 213, Louisville, KY 40222-4937
Phone: (502) 353-2074
Fax: (317) 520-8200
Mailing address: 3500 Depauw Blvd STE 3070, Indianapolis, IN 46268-6135

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-21-177138 (KY)

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Registry record

NPI: 1003581810
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Aug 2021
Record last updated: 13 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.