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General NPI Number Information
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NPI Number | 1205641800
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Entity Type | Individual
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Provider Name | PAYTON ENGELS
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 8401 OHIO
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6687
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Country | US
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Telephone | 219-525-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 13759 FREEDOM WAY
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City | CEDAR LAKE
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State | IN
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Zip | 46303-0791
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Country | US
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Telephone | 847-636-8695
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-258398
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License Number State |
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