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General NPI Number Information
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NPI Number | 1730812553
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Entity Type | Individual
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Provider Name | AUDRIANNA NICOLE KING M.A, BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 5125 DECATUR BLVD STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46241-7511
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Country | US
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Telephone | 317-315-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 3724 KNICKERBOCKER PL APT 2C
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-2196
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Country | US
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Telephone | 317-315-7001
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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 | 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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