Individual
ANIYA CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E RUDISILL BLVD, SUITE 100B, FORT WAYNE, IN 46806-1756
(260) 541-6089
Mailing address
201 EAST RUDISILL BLVD, SUITE 100B, FORT WAYNE, IN 46806
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/20/2023
Last updated
01/20/2023
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