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Individual

TIFFANY ANGEL PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCABA

Contact information

Practice address
5545 E STOP 11 RD, INDIANAPOLIS, IN 46237-8616
(317) 960-5437
Mailing address
5545 E STOP 11 RD APT C, INDIANAPOLIS, IN 46237-8616
(317) 960-5437

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-21-12839
IN
106E00000X
Assistant Behavior Analyst
Primary
0-21-12839
IN
106S00000X
Behavior Technician
RBT-18-61139
IN

Other

Enumeration date
04/22/2021
Last updated
04/29/2022
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