Healthcare Provider Details

I. General information

NPI: 1134045636
Provider Name (Legal Business Name): YASMIN SANCHEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 S EMERSON AVE STE 100
INDIANAPOLIS IN
46237-1972
US

IV. Provider business mailing address

8820 PENDLETON PIKE TRL 731
INDIANAPOLIS IN
46226-4191
US

V. Phone/Fax

Practice location:
  • Phone: 317-834-7676
  • Fax:
Mailing address:
  • Phone: 317-772-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: