Provider Demographics
NPI:1467218669
Name:ROSS, AURORA BREANN (RBT)
Entity Type:Individual
Prefix:MRS
First Name:AURORA
Middle Name:BREANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BLUE LACE DR
Mailing Address - Street 2:
Mailing Address - City:WHITELAND
Mailing Address - State:IN
Mailing Address - Zip Code:46184-7025
Mailing Address - Country:US
Mailing Address - Phone:317-603-3682
Mailing Address - Fax:
Practice Address - Street 1:160 BLUE LACE DR
Practice Address - Street 2:
Practice Address - City:WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-7025
Practice Address - Country:US
Practice Address - Phone:317-603-3682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician