| Individual Piece Aba | |
|
11160 State St Crown Point IN 46307-8608 | |
| (219) 616-4612 | |
| Not Available |
| Full Name | Individual Piece Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11160 State St, Crown Point, Indiana |
| Authorized Official Name and Position | Carly Dietz (OWNER) |
| Authorized Official Contact | 2196164612 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Individual Piece Aba 11160 State St Crown Point IN 46307-8608 Ph: () - | Individual Piece Aba 11160 State St Crown Point IN 46307-8608 Ph: (219) 616-4612 |
| NPI Number | 1265283592 |
|---|---|
| Provider Enumeration Date | 03/27/2024 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265283592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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