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1538983192
AMANDA VICKSTROM
BLOOMINGTON, IN
NPI
1538983192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IN RBT-24-391130)
Enumeration Date
2024-11-11
Last Update Date
2024-11-11
Business Address
AMANDA VICKSTROM RBT
227 W GRIMES LN
BLOOMINGTON, IN 47403-3015
Phone number: 812-322-0313
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Mailing Address
AMANDA VICKSTROM RBT
PO BOX 668
BLOOMINGTON, IN 47402-0668
Phone number: 812-322-0313
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