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General NPI Number Information
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NPI Number | 1386550531
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Entity Type | Organization
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Legal Business Name | INNER CIRCLE AUTISM NETWORK
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 1514 MARKET ST STE C125
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1979
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Country | US
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Telephone | 479-318-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 OZARK DR
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City | BRYANT
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State | AR
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Zip | 72022-4081
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RBT
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Name | JORDYN RENEE CASTON
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Credential |
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Telephone | 773-815-1899
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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 |
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License Number State |
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