Individual
DALTON STAPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1081 3RD AVE SW STE 7, CARMEL, IN 46032-7500
(317) 564-0934
Mailing address
1389 W 86TH ST # 170, INDIANAPOLIS, IN 46260-2101
(317) 564-0934
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-93394
BACB
IN
Enumeration date
06/17/2021
Last updated
06/17/2021
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