| NPI | 1457060071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN KESHERIM Member 317-936-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-10-17 |