| Marin Autism Interventions, Llc. | |
|
228 Emmanuel Way Ln Webster KY 40176-5037 | |
| (310) 560-9270 | |
| Not Available |
| Full Name | Marin Autism Interventions, Llc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 228 Emmanuel Way Ln, Webster, Kentucky |
| Authorized Official Name and Position | Shannon M Priddy-marin (LICENSED BEHAVIOR ANALYST) |
| Authorized Official Contact | 3105609270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marin Autism Interventions, Llc. 228 Emmanuel Way Ln Webster KY 40176-5037 Ph: (310) 560-9270 | Marin Autism Interventions, Llc. 228 Emmanuel Way Ln Webster KY 40176-5037 Ph: (310) 560-9270 |
| NPI Number | 1306394291 |
|---|---|
| Provider Enumeration Date | 09/20/2016 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306394291 | NPI | - | NPPES |
| 7100360170 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 101578 (Kentucky) | Primary |
Marin Autism Interventions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 228 Emmanuel Way Ln, Webster, KY 40176 Phone: 270-883-5547 |