Individual
AUTUMN BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 HIDDEN LN, TERRE HAUTE, IN 47802-4912
(812) 229-1905
Mailing address
4 HIDDEN LN, TERRE HAUTE, IN 47802-4912
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-106714
IN
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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