Individual
LISA RIVKA MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, HSPP, BCBA-D
Contact information
Practice address
1061 E SOUTHERN AVENUE, DIAGNOSTIC OFFICE, INDIANAPOLIS, IN 46203
(317) 207-1986
Mailing address
614 E 52ND ST, INDIANAPOLIS, IN 46205-1156
(410) 440-5381
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
11212660
—
103T00000X
Psychologist
Primary
20042808A
IN
Other
Enumeration date
07/09/2013
Last updated
11/08/2024
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