Provider Demographics
NPI:1124732243
Name:WILMORE BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:WILMORE BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LBA, BCBA
Authorized Official - Phone:859-963-5770
Mailing Address - Street 1:600 WOODSPOINTE WAY
Mailing Address - Street 2:
Mailing Address - City:WILMORE
Mailing Address - State:KY
Mailing Address - Zip Code:40390-1475
Mailing Address - Country:US
Mailing Address - Phone:859-963-5770
Mailing Address - Fax:
Practice Address - Street 1:600 WOODSPOINTE WAY
Practice Address - Street 2:
Practice Address - City:WILMORE
Practice Address - State:KY
Practice Address - Zip Code:40390-1475
Practice Address - Country:US
Practice Address - Phone:859-963-5770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty