Provider Demographics
NPI:1104609155
Name:ENRIQUEZ, ROBYN MARIE (RBT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:MARIE
Last Name:ENRIQUEZ
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:HELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3500 DEPAUW BLVD STE 3070
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:551 EASTPORT CENTRE DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2898
Practice Address - Country:US
Practice Address - Phone:219-255-2454
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-24-76844103K00000X
INRBT-23-289593106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician