Healthcare Provider Details

I. General information

NPI: 1598628133
Provider Name (Legal Business Name): AVERY G APPEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 3RD AVE
JASPER IN
47546-3602
US

IV. Provider business mailing address

8804 IN-257
STENDAL IN
47585
US

V. Phone/Fax

Practice location:
  • Phone: 812-670-9442
  • Fax:
Mailing address:
  • Phone: 812-457-5720
  • Fax: 812-457-5720

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: