MEDICARE: ABBY KIFFMEYER M.A. BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-20-41507	IN
2	106S00000X	Behavior Technician	RBT-16-18923	IN

General Provider Information

NPI Number	:	1083107163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY KIFFMEYER M.A. BCBA

Provider Business Mailing Address
First Line	:	9615 SHASTA DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-8324
Country	:	US
Telephone Number	:	317-679-4374
Fax Number	:	317-815-3861

Provider Business Practice Location Address
First Line	:	11807 ALLISONVILLE RD # 522
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-2313
Country	:	US
Telephone Number	:	317-572-5315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	06/02/2025

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