Provider Demographics
NPI:1568205615
Name:WAY, KHAIN NIN (RBT)
Entity type:Individual
Prefix:
First Name:KHAIN NIN
Middle Name:
Last Name:WAY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 SOUTHFAIR CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46807-3732
Mailing Address - Country:US
Mailing Address - Phone:260-557-5449
Mailing Address - Fax:
Practice Address - Street 1:5625 N GERMAN CHURCH RD STE 3117
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-8513
Practice Address - Country:US
Practice Address - Phone:718-736-5689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician