Individual
CAITLYN SHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 MERIDIAN PARKE LN, GREENWOOD, IN 46142-9406
(317) 889-5437
Mailing address
4340 SERENITY DR, COLUMBUS, IN 47203-3807
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BT
IN
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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