Individual
SHELBY PARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2630 S ARLINGTON AVE, INDIANAPOLIS, IN 46203-5701
(317) 522-1956
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
(855) 940-0177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60892
IN
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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