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General NPI Number Information
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NPI Number | 1427625565
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Entity Type | Individual
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Provider Name | MARIAH HURLEY RBT
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Gender | Female
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1061 E SOUTHERN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203
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Country | US
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Telephone | 463-701-0909
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Fax | 844-742-6592
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Provider Business Mailing Address
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Address Line | 1061 E SOUTHERN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203
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Country | US
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Telephone | 317-914-3176
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Fax | 844-742-6592
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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 | 1-24-75543
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License Number State |
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