Most Relevant Information
Provider Data
| NPI Number: | 1003304429 |
| Provider Name: | MALLARY M KASSEL RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/01/2018 |
| Last Updated: | 05/01/2018 |
Provider Practice Location
3101 N CANTERBURY CT
BLOOMINGTON
IN
474041500
Practice Location Phone/Fax
| Phone: | 8126503032 |
| Fax: | 3176631175 |
Provider Mailing Location
12650 HAMILTON CROSSING BLVD
CARMEL
IN
460325400
Provider Mailing Phone/Fax
| Phone: | 3172492242 |
| Fax: | 3176631175 |