Ellen Avery

NPI #1144037995 in South Bend, Indiana

Provider Information

NPI Number: 1144037995
Entity Type: Individual
Name: Ellen Avery
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 16, 2024
Last Updated: Dec 16, 2024

Practice Location

Address: 2505 E JEFFERSON BLVD
City: South Bend
State: Indiana
ZIP Code: 46615-2635
Phone: (574) 289-4831

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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