Individual
ALEX ALBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
790 S BASSWOOD DR APT F, BLOOMINGTON, IN 47403-2896
(765) 430-3435
Mailing address
790 S BASSWOOD DR APT F, BLOOMINGTON, IN 47403-2896
(765) 430-3435
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IN
Other
Enumeration date
06/13/2022
Last updated
03/18/2025
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