Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ROBERT PETTIBONE, BCBA
Active Sole ProprietorROBERT PETTIBONE, BCBA is a Behavior Analyst healthcare provider located in FORT WAYNE, Indiana. NPI 1154917052 is currently active in the NPPES registry. Verify at CMS.
Behavior Analyst · FORT WAYNE, IN
Registration Details
- NPI Number
- 1154917052
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 15, 2020 (5.5176676615619 yrs)
- Last Updated
- Aug 13, 2021
- License
-
1-19-40238 (IN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4719 S CALHOUN STFORT WAYNE, IN, 468072811Browse IN providers · Browse ZIP 46807
- Phone
- 2607050522
- Primary Specialty
-
Behavior Analyst
103K00000X
Other Behavior Analyst Providers in FORT WAYNE, IN
| Name | Credential | NPI |
|---|---|---|
| MRS. RACHEL MAE MILLER | MA, BCBA, LLP | 1891954665 |
| MS. LIZBETH ANN ANDERSON | M.S., BCBA | 1417186180 |
| MISS EVONNE NA THOMAS I | NURSE ASSISTANT | 1306168877 |
| AMY BENILDE COOPER | EDD, BCBA | 1871802991 |
| PAUL DAVID MCCOMAS | BS, BCBA | 1255640371 |
| MRS. REBECCA MARIE-ROSE FULCHER | M.A., BCBA | 1366744518 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.