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10475 Crosspoint Blvd Ste 250 Indianapolis IN 46256-3387 | |
| (732) 806-0091 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10475 Crosspoint Blvd Ste 250, Indianapolis, Indiana |
| Authorized Official Name and Position | Matt Rokowsky (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 7328060091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
185 Route 70 Ste 302 Toms River NJ 08755-0936 Ph: (732) 806-0091 | 10475 Crosspoint Blvd Ste 250 Indianapolis IN 46256-3387 Ph: (732) 806-0091 |
| NPI Number | 1376119099 |
|---|---|
| Provider Enumeration Date | 06/02/2021 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376119099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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