Individual
KELLY MYNATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2630 S ARLINGTON AVE, INDIANAPOLIS, IN 46203-5701
(317) 966-0200
Mailing address
2630 S ARLINGTON AVE, INDIANAPOLIS, IN 46203-5701
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14002
IN
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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