Healthcare Provider Details

I. General information

NPI: 1811437502
Provider Name (Legal Business Name): BILLIE ANN ISAACS MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4821 OLD NATIONAL RD E STE C
RICHMOND IN
47374-2651
US

IV. Provider business mailing address

3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 765-598-4197
  • Fax: 765-450-6664
Mailing address:
  • Phone: 885-324-0885
  • Fax: 765-450-6664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-24702
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: