Healthcare Provider Details

I. General information

NPI: 1043037963
Provider Name (Legal Business Name): VANESSA ARMOUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 CRAIG ST
INDIANAPOLIS IN
46250-3593
US

IV. Provider business mailing address

8350 CRAIG ST
INDIANAPOLIS IN
46250-3593
US

V. Phone/Fax

Practice location:
  • Phone: 317-578-0410
  • Fax:
Mailing address:
  • Phone: 317-578-0410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-386399
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: