Provider Demographics
NPI:1538663364
Name:GUTMANN, ANNE ELAINE (MED, BCBA, COBA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ELAINE
Last Name:GUTMANN
Suffix:
Gender:F
Credentials:MED, BCBA, COBA
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:ELAINE
Other - Last Name:MAGLIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA, COBA
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:6085 EMERALD PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3269
Practice Address - Country:US
Practice Address - Phone:614-482-4300
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-18-32060103K00000X
OHCOBA.00487103K00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator