Provider Demographics
NPI:1104378991
Name:KNEE, JAIMIE (BCBA)
Entity Type:Individual
Prefix:MISS
First Name:JAIMIE
Middle Name:
Last Name:KNEE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3219
Mailing Address - Country:US
Mailing Address - Phone:317-584-5166
Mailing Address - Fax:317-815-3861
Practice Address - Street 1:3435 W 96TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1102
Practice Address - Country:US
Practice Address - Phone:178-027-4473
Practice Address - Fax:317-802-7325
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-16-23756103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst