Provider Demographics
NPI:1245993815
Name:INDY PRECISION LEARNING LLC
Entity type:Organization
Organization Name:INDY PRECISION LEARNING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WORLAND
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:317-662-0460
Mailing Address - Street 1:6630 LAKESTONE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-9003
Mailing Address - Country:US
Mailing Address - Phone:317-519-6692
Mailing Address - Fax:
Practice Address - Street 1:6630 LAKESTONE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-9003
Practice Address - Country:US
Practice Address - Phone:317-519-6692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty