Individual
BIANCA MARIE MAMAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 TUTOR LN STE 107, EVANSVILLE, IN 47715-7295
(812) 602-1038
Mailing address
900 TUTOR LN STE 107, EVANSVILLE, IN 47715-7295
(812) 602-1038
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-346066
IN
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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