Individual
MAYA VAILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 N LIBERTY CIRCLE DRIVE W, GRENNSBURG, IN 47240-1303
(812) 663-2273
(812) 663-2275
Mailing address
1314 N LIBERTY CIRCLE DRIVE W, GRENNSBURG, IN 47240-1303
(812) 663-2273
(812) 663-2275
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14908
IN
106S00000X
Behavior Technician
RBT-21-161649
IN
Other
Enumeration date
07/29/2021
Last updated
01/08/2024
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