Provider Demographics
NPI:1326402678
Name:MORONES, SYLVIA (BCABA)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:MORONES
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:DRAPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:6060 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1907
Mailing Address - Country:US
Mailing Address - Phone:317-584-5166
Mailing Address - Fax:317-815-3861
Practice Address - Street 1:12912 COLDWATER RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-8870
Practice Address - Country:US
Practice Address - Phone:260-245-1455
Practice Address - Fax:317-815-3861
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst