Provider Demographics
NPI:1073077384
Name:NELSON, ROBYN KAE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:KAE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:KAE
Other - Last Name:ORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12650 HAMILTON CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5400
Mailing Address - Country:US
Mailing Address - Phone:317-249-2242
Mailing Address - Fax:317-663-1175
Practice Address - Street 1:12650 HAMILTON CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5400
Practice Address - Country:US
Practice Address - Phone:317-249-2242
Practice Address - Fax:317-663-1175
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst