Individual
JACK GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3650 E SUMNER AVE, INDIANAPOLIS, IN 46237-1209
(812) 205-9219
Mailing address
3650 E SUMNER AVE, INDIANAPOLIS, IN 46237-1209
(812) 205-9219
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB365678
IN
Other
Enumeration date
07/26/2019
Last updated
12/16/2025
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