NPI 1003606153

Anna Dickerson

Practitioner Behavior Technician Fort Wayne, IN

Practice location

Address: 6131 N Clinton St, Fort Wayne, IN 46825-4905
Phone: (260) 459-6040
Mailing address: 5601 Coventry Ln, Fort Wayne, IN 46804-7145

Registered specialties

Behavior Technician Primary

Behavioral Health & Social Service Providers Taxonomy 106S00000X Licence RBT-25-413845 (IN)

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Registry record

NPI: 1003606153
Entity type: Individual
Sex (as registered): X
NPI issued: 12 May 2025
Record last updated: 12 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.