MEDICARE: DANIELLE DEAN RBT

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
1	106S00000X	Behavior Technician	RBT-21-192576	IN

General Provider Information

NPI Number	:	1285390245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE DEAN RBT

Provider Business Mailing Address
First Line	:	11807 ALLISONVILLE RD # 522
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-2313
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1024 S 6TH ST
Second Line	:
City	:	TERRE HAUTE
State	:	IN
Zip	:	47807-5015
Country	:	US
Telephone Number	:	317-572-5315
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2021
Last Update Date	:	03/25/2026

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Directions to “ DANIELLE DEAN RBT” Practice Location

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