Robert Pettibone, BCBA

NPI #1154917052 in Fort Wayne, Indiana

Provider Information

NPI Number: 1154917052
Entity Type: Individual
Name: Robert Pettibone, BCBA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Credential: BCBA
Enumeration Date: Dec 15, 2020
Last Updated: Aug 13, 2021

Practice Location

Address: 4719 S CALHOUN ST
City: Fort Wayne
State: Indiana
ZIP Code: 46807-2811
Phone: (260) 705-0522

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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