Provider Demographics
NPI:1558179598
Name:PATTINSON, NICHOLAS (RBT)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:PATTINSON
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 LIBRARY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1567
Mailing Address - Country:US
Mailing Address - Phone:317-881-9923
Mailing Address - Fax:317-881-9966
Practice Address - Street 1:1180 S LIBERTY DR STE 410
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-5178
Practice Address - Country:US
Practice Address - Phone:317-881-9923
Practice Address - Fax:317-881-9966
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician