Individual
GRACE KINDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
695 3RD AVE, JASPER, IN 47546-3602
(404) 400-5004
Mailing address
8616 GULF DR APT D, FORT WAYNE, IN 46825-6621
(574) 312-0737
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
IN
106E00000X
Assistant Behavior Analyst
—
IN
106S00000X
Behavior Technician
—
IN
Other
Enumeration date
07/09/2021
Last updated
02/10/2025
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