Provider Demographics
NPI:1346733425
Name:CIMINO, AMY LOUISE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LOUISE
Last Name:CIMINO
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 1:5731 WALKABOUT WAY
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-2913
Mailing Address - Country:US
Mailing Address - Phone:317-697-8535
Mailing Address - Fax:
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:317-222-1242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INBACB356815103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst