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NPI 1619782067

NPI 1619782067 : ANTHONY DEWAYNE MURPHY RBT : ALEXANDRIA, IN

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General NPI Number Information
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    NPI Number           |    1619782067
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    Entity Type          |    Individual 
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    Provider Name        |    ANTHONY DEWAYNE MURPHY RBT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/12/2025
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    Last Update Date     |    02/12/2025
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Provider Practice Location Address
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    Address Line         |    2211 S PARK AVE 
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    City                 |    ALEXANDRIA
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    State                |    IN
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    Zip                  |    46001-8084
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    Country              |    US
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    Telephone            |    765-705-4138
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1511 W 7TH ST 
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    City                 |    MUNCIE
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    State                |    IN
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    Zip                  |    47302-2110
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    Country              |    US
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    Telephone            |    260-416-8116
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    Fax                  |    
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    RBT-23-282271
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    License Number State |    IN
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