Individual
ANTHONY ADAME HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9769 CROSSPOINT BLVD, INDIANAPOLIS, IN 46256-3346
(317) 588-2732
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-111268
IN
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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