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General NPI Number Information
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NPI Number | 1053874099
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Entity Type | Individual
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Provider Name | KYLE SABELHAUS MA, BCBA, LBA
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Gender | Male
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 21 S PARK BLVD STE 21
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City | GREENWOOD
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State | IN
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Zip | 46143-8838
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Country | US
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Telephone | 317-449-2104
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Fax |
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Provider Business Mailing Address
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Address Line | 201 N ILLINOIS ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-1904
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Country | US
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Telephone | 463-777-8323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-63873
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License Number State | IN
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