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General NPI Number Information
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NPI Number | 1326830647
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Entity Type | Individual
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Provider Name | CHEYENNE MATHAS
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Gender | Female
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 205 W FRANCISCAN DR
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City | CROWN POINT
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State | IN
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Zip | 46307-4802
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Country | US
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Telephone | 888-998-5269
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Fax |
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Provider Business Mailing Address
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Address Line | 10475 CROSSPOINT BLVD STE 250
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3387
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Country | US
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Telephone | 462-205-0087
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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-25-436386
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | IN
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