Individual
MARY ROBINETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2519 E 10TH ST, ANDERSON, IN 46012-4463
(765) 393-3031
Mailing address
2519 E 10TH ST, ANDERSON, IN 46012-4463
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-17589
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018669
—
IN
Enumeration date
08/31/2018
Last updated
06/28/2019
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