Taelyr Renee Bruther, RBT

Individual provider Active NPI Assistant Behavior Analyst · Shelbyville, IN

NPI 1033869508 · NPPES record last updated Mar 27, 2022

Key facts

NPI
1033869508
Entity type
Individual (NPI type 1)
Primary specialty
Assistant Behavior Analyst 106E00000X
Practice address
120 W Jackson St
Shelbyville, IN 46176-1295
Phone
(317) 512-2101
NPI assigned
Mar 27, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Yes

Addresses

Primary practice location

120 W Jackson St
Shelbyville, IN 46176-1295

Mailing address

530 Hickory Dr
Hanover, IN 47243-9451
Phone (812) 818-0735

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address mpoe@btlautism.com Health Information Exchange (HIE)

Other providers in Shelbyville, IN

All providers in Shelbyville, IN · Assistant Behavior Analyst in Indiana

Sources for this page

Verify at the official NPI Registry.