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General NPI Number Information
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NPI Number | 1841098431
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Entity Type | Individual
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Provider Name | JORDYN LEIGH FRALICK RBT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1030 N SR 37
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City | ELWOOD
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State | IN
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Zip | 46036
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Country | US
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Telephone | 765-617-2279
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Fax | 765-274-5244
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Provider Business Mailing Address
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Address Line | 102 E NORTH MAIN ST
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City | SUMMITVILLE
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State | IN
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Zip | 46070-9322
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Country | US
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Telephone | 765-617-0681
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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-24-365105
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License Number State | IN
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