Individual
BAILEY R HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7105 GALEN DR W, AVON, IN 46123-8450
(317) 373-1369
Mailing address
7105 GALEN DR W, AVON, IN 46123
(317) 373-1369
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-296257
IN
Other
Enumeration date
01/29/2025
Last updated
03/19/2025
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