Individual
AMANDA HENNESSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
227 W GRIMES LN, BLOOMINGTON, IN 47403-3015
(812) 322-0313
Mailing address
PO BOX 668, BLOOMINGTON, IN 47402-0668
(812) 322-0313
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
11/30/2022
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