Individual
TIFFANY ANN ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2630 S ARLINGTON AVE, INDIANAPOLIS, IN 46203-5701
(317) 522-1956
Mailing address
8841 BUCKEYE DR APT 332, INDIANAPOLIS, IN 46237-9173
(317) 625-8533
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78553
IN
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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