Individual
AMANDA WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
Mailing address
8350 CRAIG ST, INDIANAPOLIS, IN 46250-3593
(317) 578-0410
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79754
IN
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/19/2023
Last updated
04/07/2025
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