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NPI Code Detail

MEDICARE: TRINITY KYLE

MEDICARE: TRINITY KYLE
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
1106S00000XBehavior TechnicianRBT-24-381984IN
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1205648656
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRINITY KYLE
Provider Business Mailing Address
First Line : 11820 IGNEOUS DR
Second Line :
City : FISHERS
State : IN
Zip : 46038-4811
Country : US
Telephone Number : 317-646-2358
Fax Number :
Provider Business Practice Location Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-578-0410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2025
Last Update Date : 05/20/2025

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Directions to “ TRINITY KYLE ” Practice Location

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