Individual
TANNA K BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
4126 S 7TH ST, TERRE HAUTE, IN 47802-4123
(812) 645-2308
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(885) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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