Individual
ALEXA GAITAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Credential
RBT
Contact information
Practice address
4118 N CLINTON ST, FORT WAYNE, IN 46805-1210
(502) 795-0773
Mailing address
3006 EASTPOINT PKWY, LOUISVILLE, KY 40223-4185
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-327484
IN
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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