Individual
AMANDA JO BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4079 N 500 W, BARGERSVILLE, IN 46106-9249
(317) 887-4200
Mailing address
290 THREE NOTCH LN, BARGERSVILLE, IN 46106-9726
(317) 400-9195
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1183395
IN
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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