Elijah Drake, RBT
Behavior Technician in Indianapolis, IN. Individual provider (NPI-1).
NPI number1053124180
StatusActive
Last updated in NPPESJan 31, 2025
Details
- NPI
- 1053124180
- Entity type
- Individual (NPI-1)
- Name
- Elijah Drake
- Credential
- RBT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 31, 2025
- Certification date
- Jan 31, 2025
- Last updated
- Jan 31, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1022 E 52nd StIndianapolis, IN 46205-1205
Phone 317-815-5501
Mailing address
2628 N Lasalle StIndianapolis, IN 46218-2860
Phone 812-767-6463
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