Provider Demographics
NPI:1386254571
Name:BRADLEY, KARI MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:MARIE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:MARIE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:209 WEBSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-6523
Mailing Address - Country:US
Mailing Address - Phone:502-439-5295
Mailing Address - Fax:
Practice Address - Street 1:6435 W HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014-8502
Practice Address - Country:US
Practice Address - Phone:502-439-5295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst