Individual
AMANDA NICOLE BUTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
9426 LIMA RD, FORT WAYNE, IN 46818-8680
(260) 497-0328
(260) 497-0904
Mailing address
2270 LAKE AVE, FORT WAYNE, IN 46805-5359
(260) 444-5649
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
01/28/2019
Last updated
07/06/2025
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