Elise Dashae Anderson, BA, RBT

Individual provider Active NPI Behavior Technician · Bowling Green, KY

NPI 1720849201 · NPPES record last updated Jan 22, 2024

Key facts

NPI
1720849201
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-305260
Practice address
2427 Russellville Rd
Bowling Green, KY 42101-3980
Phone
(270) 936-7472
Fax
(317) 520-8200
NPI assigned
Jan 22, 2024
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
Credentials
Bachelor of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-305260 Yes

Addresses

Primary practice location

2427 Russellville Rd
Bowling Green, KY 42101-3980

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other providers in Bowling Green, KY

All providers in Bowling Green, KY · Behavior Technician in Kentucky

Sources for this page

Verify at the official NPI Registry.