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Individual

CARLEE GRACE FELLABAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3601 W BETHEL AVE, MUNCIE, IN 47304-5408
(765) 282-8222
Mailing address
3601 W BETHEL AVE, MUNCIE, IN 47304-5408
(765) 282-8222

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
IN
01
568946544
BCBS
01
5874
HEALTHPARTNERS
Enumeration date
09/09/2025
Last updated
09/09/2025
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