MEDICARE: HALLE MARIE LASWELL 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-24-387379	IN

General Provider Information

NPI Number	:	1982425872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLE MARIE LASWELL RBT

Provider Business Mailing Address
First Line	:	900 TUTOR LN STE 107
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-7295
Country	:	US
Telephone Number	:	812-602-1038
Fax Number	:	812-602-1048

Provider Business Practice Location Address
First Line	:	556 S WASHINGTON ST
Second Line	:
City	:	DALE
State	:	IN
Zip	:	47523
Country	:	US
Telephone Number	:	812-330-4460
Fax Number	:	812-330-4461

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

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	03/03/2026

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Directions to “ HALLE MARIE LASWELL RBT” Practice Location

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