Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1033619341 |
---|---|
Provider Name | Sara Callaghan |
First Address | Indianapolis, IN 46220-1907 |
Second Address | Fort Wayne, IN 46845-1721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2018 |
Last Update Date | 24/04/2019 |