Healthcare Provider Details

I. General information

NPI: 1780521104
Provider Name (Legal Business Name): ESPECTRO ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 THAMES AVE
LAFAYETTE IN
47909-2983
US

IV. Provider business mailing address

314 THAMES AVE
LAFAYETTE IN
47909-2983
US

V. Phone/Fax

Practice location:
  • Phone: 765-357-1449
  • Fax:
Mailing address:
  • Phone: 765-357-1449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SANDY AMADOR
Title or Position: MANAGING MEMBER
Credential: BCBA
Phone: 765-357-1449