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Individual

CHANDLER MILLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS, MS, RBT

Contact information

Practice address
2134 HOLIDAY LN, FRANKLIN, IN 46131-2600
(317) 474-8512
Mailing address
39 ESTATE DR, BROOKVILLE, OH 45309-9207
(317) 560-2223

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-173286
IN

Other

Enumeration date
09/02/2021
Last updated
08/30/2023
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