Individual
CARLY JEAN CHIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, COBA
Contact information
Practice address
703 STATE ROUTE 28, MILFORD, OH 45150
(513) 831-2578
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.00497
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-14-17170
BCBA CERTIFICATE
—
Enumeration date
08/24/2009
Last updated
01/07/2019
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