Healthcare Provider Details

I. General information

NPI: 1477997377
Provider Name (Legal Business Name): REBECCA ANN BATTERMAN MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12726 HAMILTON CROSSING BLVD
CARMEL IN
46032-5422
US

IV. Provider business mailing address

12726 HAMILTON CROSSING BLVD
CARMEL IN
46032-5422
US

V. Phone/Fax

Practice location:
  • Phone: 317-249-2245
  • Fax: 317-249-2248
Mailing address:
  • Phone: 317-249-2245
  • Fax: 317-249-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-13-13122
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: