Individual
AUSTIN-IAN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5719 S MADISON AVE, ANDERSON, IN 46013-1651
(765) 606-4995
Mailing address
5719 S MADISON AVE, ANDERSON, IN 46013-1651
(765) 606-4995
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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