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NPI Code Detail

MEDICARE: JAELYNN ROEDER

MEDICARE: JAELYNN ROEDER
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 Technician

General Provider Information

NPI Number : 1255271714
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAELYNN ROEDER
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number :
Provider Business Practice Location Address
First Line : 3771 S A ST
Second Line :
City : RICHMOND
State : IN
Zip : 47374-6053
Country : US
Telephone Number : 765-598-4197
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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Directions to “ JAELYNN ROEDER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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