Individual
DOMMINIQUE CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
201 N ILLINOIS ST, 16TH FL SOUTH TOWER, INDIANAPOLIS, IN 46204-4232
(463) 244-5821
Mailing address
201 N ILLINOIS ST, INDIANAPOLIS, IN 46204-4232
(463) 244-5821
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-274670
IN
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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