Most Relevant Information
Provider Data
| NPI Number: | 1003681404 |
| Provider Name: | ALEXIS SUTTLES RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-299154 |
Most Important Dates
| Enumeration Date: | 11/16/2023 |
| Last Updated: | 11/16/2023 |
Provider Practice Location
3338 TRICKUM RD
WOODSTOCK
GA
301884242
Practice Location Phone/Fax
| Phone: | 4704720039 |
| Fax: | 3175208200 |
Provider Mailing Location
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS
IN
462686135
Provider Mailing Phone/Fax
| Phone: | 8553240885 |
| Fax: | 3175208200 |