Individual
MICHELLE VICTORIA BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2301 W BRADLEY AVE, CHAMPAIGN, IL 61821-1849
(574) 387-4313
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
16-13078
—
Other
Enumeration date
04/24/2018
Last updated
03/25/2022
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