Individual
KENNETH WEADICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
360 POLK ST, GREENWOOD, IN 46143-1623
(317) 888-1557
(317) 888-1571
Mailing address
360 POLK ST, GREENWOOD, IN 46143-1623
(317) 888-1557
(317) 888-1571
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1073710
IN
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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