Provider Demographics
NPI:1679246565
Name:KOTTLOWSKI, HANNA (BCBA)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:KOTTLOWSKI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 LOCUST DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-6706
Mailing Address - Country:US
Mailing Address - Phone:317-828-3568
Mailing Address - Fax:
Practice Address - Street 1:2821 LOCUST DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-6706
Practice Address - Country:US
Practice Address - Phone:317-828-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst