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NPI Code Detail

MEDICARE: MISS JAIMIE KNEE BCBA

MEDICARE: MISS JAIMIE KNEE BCBA
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 Analyst1-16-23756IN

General Provider Information

NPI Number : 1104378991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JAIMIE KNEE BCBA
Provider Business Mailing Address
First Line : 1025 E 54TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-3219
Country : US
Telephone Number : 317-584-5166
Fax Number : 317-815-3861
Provider Business Practice Location Address
First Line : 3435 W 96TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1102
Country : US
Telephone Number : 178-027-4473
Fax Number : 317-802-7325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2016
Last Update Date : 06/14/2019

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Directions to “ MISS JAIMIE KNEE BCBA” Practice Location

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