Provider Demographics
NPI:1841186640
Name:WELLS, AIRIYANNA
Entity type:Individual
Prefix:
First Name:AIRIYANNA
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3277 SWANSON CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-4877
Mailing Address - Country:US
Mailing Address - Phone:269-271-4992
Mailing Address - Fax:
Practice Address - Street 1:3815 RIVER CROSSING PKWY STE 100
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-7766
Practice Address - Country:US
Practice Address - Phone:317-426-9989
Practice Address - Fax:317-932-9789
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-22-206897103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst