Individual
CHEYENNE PECONGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6506 COVINGTON RD, FORT WAYNE, IN 46804-7349
(260) 257-1735
Mailing address
120 E MARKET ST, INDIANAPOLIS, IN 46204-3250
(404) 400-5004
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-327478
IN
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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