Individual
AMY LYNN COSTIDAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
12650 HAMILTON CROSSING BLVD, CARMEL, IN 46032-5400
(317) 249-2242
(317) 249-2248
Mailing address
12650 HAMILTON CROSSING BLVD, CARMEL, IN 46032-5400
(317) 249-2242
(317) 249-2248
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24212
IN
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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