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General NPI Number Information
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NPI Number | 1689127946
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Entity Type | Organization
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Legal Business Name | BDG OF IN, INC
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 120 E MARKET ST STE 1223
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-3250
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Country | US
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Telephone | 888-964-5428
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Fax |
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Provider Business Mailing Address
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Address Line | 120 E MARKET ST STE 1223
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-3250
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Country | US
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Telephone | 888-964-5428
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIEL RAGER
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Credential |
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Telephone | 888-964-5428
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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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