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General NPI Number Information
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NPI Number | 1366035826
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Entity Type | Organization
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Legal Business Name | KINDRED TIES THERAPY, LLC
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2369 BEAM RD
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City | COLUMBUS
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State | IN
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Zip | 47203-3404
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Country | US
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Telephone | 812-900-5463
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Fax | 855-919-4295
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Provider Business Mailing Address
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Address Line | 2369 BEAM RD
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City | COLUMBUS
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State | IN
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Zip | 47203-3404
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Country | US
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Telephone | 812-900-5463
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Fax | 855-919-4295
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | MISS CHELSEA WAXLER
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Credential | MA, BCBA
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Telephone | 812-350-7606
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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 |
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License Number State |
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