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1972125649
ELLIOT LAKES
MUNCIE, IN
NPI
1972125649
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: IN RBT-19-76471)
Enumeration Date
2020-05-15
Last Update Date
2020-05-15
Business Address
ELLIOT LAKES
4105 N WALNUT ST
MUNCIE, IN 47303-5904
Phone number: 765-587-5244
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Mailing Address
ELLIOT LAKES
4105 N WALNUT ST
MUNCIE, IN 47303-5904
Phone number: 765-587-5244
Copy
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