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NPI Code Detail

MEDICARE: DANOSHLEY BERNADOTTE MA, BCBA

MEDICARE: DANOSHLEY BERNADOTTE MA, 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1508631433
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANOSHLEY BERNADOTTE MA, BCBA
Provider Business Mailing Address
First Line : 1022 E 52ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1022 E 52ND ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1205
Country : US
Telephone Number : 317-978-0708
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2023
Last Update Date : 11/21/2023

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