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NPI Code Detail

MEDICARE: GUIDED PRACTICE

MEDICARE: GUIDED PRACTICE
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 : 1407784572
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUIDED PRACTICE
Provider Business Mailing Address
First Line : 3130 STATE LINE RD BLDG B
Second Line :
City : NORTH BEND
State : OH
Zip : 45052-9731
Country : US
Telephone Number : 812-890-3358
Fax Number :
Provider Business Practice Location Address
First Line : 3130 STATE LINE RD BLDG B
Second Line :
City : NORTH BEND
State : OH
Zip : 45052-9731
Country : US
Telephone Number : 812-890-3358
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CALLIE GARTENMAN
Credential :
Telephone Number : 812-890-3358
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “GUIDED PRACTICE ” Practice Location

Language Start Address Practice Location
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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