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General NPI Number Information
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NPI Number | 1427620822
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Entity Type | Individual
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Provider Name | MARIAH LYNN BABCOCK
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Gender | Female
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 6005 LANDERHAVEN DR STE B1
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-4042
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Country | US
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Telephone | 614-681-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 DEPAUW BLVD STE 3070
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-6135
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Country | US
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Telephone | 855-324-0885
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Fax | 317-520-8200
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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 | 1-23-65879
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License Number State |
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