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Individual

DAVID VANDEVENTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BCBA

Contact information

Practice address
708 W 11TH ST, BLOOMINGTON, IN 47404-3202
(812) 606-0609
Mailing address
708 W 11TH ST, BLOOMINGTON, IN 47404-3202
(812) 606-0609

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18443

Other

Enumeration date
08/03/2015
Last updated
08/03/2015
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