Provider Demographics
NPI:1164233680
Name:DUTTLINGER, AMBER L
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:L
Last Name:DUTTLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:DOVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8520 ALLISON POINTE BLVD # 233
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-5700
Mailing Address - Country:US
Mailing Address - Phone:574-200-0038
Mailing Address - Fax:
Practice Address - Street 1:8520 ALLISON POINTE BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-5700
Practice Address - Country:US
Practice Address - Phone:574-200-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-25-404254106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician