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General NPI Number Information
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NPI Number | 1508746850
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Entity Type | Organization
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Legal Business Name | MAWEH APPLIED BEHAVIOR ANALYSIS (MABA)
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 3500 DEPAUW BLVD STE 1110
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1136
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Country | US
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Telephone | 833-674-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 DEPAUW BLVD STE 1110
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1136
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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 | REGISTERED AGENT
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Name | NORTHWEST REGISTERED AGENT
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Credential |
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Telephone | 833-674-8623
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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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