Individual
KRISTIN M RANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA,LBA
Contact information
Practice address
12625 WALROND RD, FISHERS, IN 46037-6632
(541) 241-6446
Mailing address
12625 WALROND RD, FISHERS, IN 46037-6632
(541) 241-6446
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-34941
IN
106S00000X
Behavior Technician
ABA-IN-10174842
OR
Other
Enumeration date
02/09/2016
Last updated
11/03/2021
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