Provider Demographics
NPI:1235941899
Name:ANGLIN, ASPEN NICHOLE (RBT)
Entity type:Individual
Prefix:
First Name:ASPEN
Middle Name:NICHOLE
Last Name:ANGLIN
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 1:114 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-4529
Mailing Address - Country:US
Mailing Address - Phone:765-419-0411
Mailing Address - Fax:
Practice Address - Street 1:114 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-4529
Practice Address - Country:US
Practice Address - Phone:765-419-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-23-264749106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician