Individual
BASMA ALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 W JACKSON ST STE BC, SHELBYVILLE, IN 46176-1295
(317) 512-2101
Mailing address
120 W JACKSON ST STE BC, SHELBYVILLE, IN 46176-1295
(317) 512-2101
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IN
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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