Individual
COREY WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8520 ALLISON POINTE BLVD STE 223, INDIANAPOLIS, IN 46250-4299
(574) 876-5705
Mailing address
2813 NORTHSIDE BLVD, SOUTH BEND, IN 46615-1833
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-396224
IN
Other
Enumeration date
02/07/2025
Last updated
04/25/2025
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