Healthcare Provider Details

I. General information

NPI: 1245134972
Provider Name (Legal Business Name): NATALLY GARDUNO-SAUCEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NATALLY GARDUNO

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N ILLINOIS ST
INDIANAPOLIS IN
46204-1904
US

IV. Provider business mailing address

2390 WEDGEWOOD DR UNIT 6250
AKRON OH
44312-2479
US

V. Phone/Fax

Practice location:
  • Phone: 317-537-0987
  • Fax: 855-892-0299
Mailing address:
  • Phone: 888-238-1818
  • Fax: 855-915-1521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2857132
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: