Individual
BLAIR AMBER GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
RISE AUTISM THERAPY SERVICES, 239 E WINSLOW RD, BLOOMINGTON, IN 47401
(812) 202-6001
(812) 954-0256
Mailing address
RISE AUTISM THERAPY SERVICES, 239 E WINSLOW RD, BLOOMINGTON, IN 47401
(812) 887-4288
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BCBA1-23-65449
IN
106S00000X
Behavior Technician
RBT-19-106721
IN
Other
Enumeration date
10/02/2020
Last updated
05/14/2024
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