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Robert Pettibone, BCBA
NPI 1154917052 · on the registry since 2020 · sole proprietor
Practice
- Address
- 4719 S Calhoun St
Fort Wayne, IN 46807 - Phone
- (260) 705-0522
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Behavior Analyst
103K00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-08-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana