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NPI Code Detail

MEDICARE: LACEY SCHOFFSTALL RBT

MEDICARE:   LACEY  SCHOFFSTALL  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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841862083
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY SCHOFFSTALL RBT
Provider Business Mailing Address
First Line : 8350 CRAIG ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-3593
Country : US
Telephone Number : 317-578-0410
Fax Number : 317-436-7409
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 : 317-436-7409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2021
Last Update Date : 03/19/2026

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Directions to “ LACEY SCHOFFSTALL RBT” Practice Location

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