Provider Demographics
NPI:1578221701
Name:GRALEY, DEVIN N (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:N
Last Name:GRALEY
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RAND AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-1455
Mailing Address - Country:US
Mailing Address - Phone:606-407-1521
Mailing Address - Fax:
Practice Address - Street 1:125 RAND AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-1455
Practice Address - Country:US
Practice Address - Phone:606-407-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY274515103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst