Healthcare Provider Details

I. General information

NPI: 1437030566
Provider Name (Legal Business Name): BRIANNA SYKES RBT
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 S MERIDIAN ST
INDIANAPOLIS IN
46217-3764
US

IV. Provider business mailing address

3006 EASTPOINT PKWY
LOUISVILLE KY
40223-4185
US

V. Phone/Fax

Practice location:
  • Phone: 502-795-0773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-465954
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: