Individual
MOLLY KATHERINE WERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
360 POLK ST, GREENWOOD, IN 46143-1623
(317) 888-1557
Mailing address
360 POLK ST, GREENWOOD, IN 46143-1623
(317) 888-1557
(317) 888-1571
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-41770
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07151992
DOB
IN
Enumeration date
03/05/2020
Last updated
03/05/2020
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