Individual
ANGELA L KEPPOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5601 COVENTRY LANE, FORT WAYNE, IN 46804
(260) 459-6040
Mailing address
7027 STRAWBERRY DR, FORT WAYNE, IN 46825-3651
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
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