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General NPI Number Information
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NPI Number | 1942018288
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Entity Type | Individual
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Provider Name | BAILEY JO HARRIS
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 10475 CROSSPOINT BLVD STE 250
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3387
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Country | US
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Telephone | 462-205-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 10475 CROSSPOINT BLVD STE 250
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3387
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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 |
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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-22-212552
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License Number State |
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