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NPI Code Detail

MEDICARE: PARTNERS IN AUTISM

MEDICARE: PARTNERS IN AUTISM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1104236272
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARTNERS IN AUTISM
Provider Business Mailing Address
First Line : 601 NOBLE DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5544
Country : US
Telephone Number : 260-420-9332
Fax Number : 866-446-0198
Provider Business Practice Location Address
First Line : 601 NOBLE DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5544
Country : US
Telephone Number : 260-420-9332
Fax Number : 866-446-0198
Authorized Official
Title or Position : OWNER
Name : MR. WILLIAM T GUEST
Credential :
Telephone Number : 260-420-9332
Provider Enumeration Date : 04/29/2014
Last Update Date : 12/12/2024

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Directions to “PARTNERS IN AUTISM ” Practice Location

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