Individual
ALIE MARIE KOTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, COBA
Contact information
Practice address
773 BROOKSEDGE BLVD, WESTERVILLE, OH 43081-2821
(614) 401-3366
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.00378
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-26118
BCBA CERTIFICATE
—
Enumeration date
12/15/2016
Last updated
04/17/2020
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