Individual
ANDY PICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9301 S INNOVATION DR STE 103, DALEVILLE, IN 47334-9517
(057) 438-7431
Mailing address
215 RED COACH DR., MISHAWAKA, IN 46545-8307
(057) 438-7431
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-188030
IN
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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