Individual
TRAVIS JOHN ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6655 E US HIGHWAY 36 # 179, AVON, IN 46123-8923
(888) 714-1927
Mailing address
5101 E US HIGHWAY 36 STE 100, AVON, IN 46123-6646
(888) 714-1927
(317) 745-9565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/27/2019
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