Individual
ELLA DORON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
Mailing address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-24-356739
IN
224Z00000X
Occupational Therapy Assistant
Primary
32003885A
IN
Other
Enumeration date
07/05/2024
Last updated
02/13/2025
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