Individual
AUSTIN ROSS BERNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 W TAYLOR ST, KOKOMO, IN 46901-4554
(765) 419-0411
Mailing address
5501 MENOMONEE DR, KOKOMO, IN 46902-5447
(765) 271-7286
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB452883
IN
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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