Provider Demographics
NPI:1538596176
Name:APRAEZ, STACY LYNNE (BCBA)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LYNNE
Last Name:APRAEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LYNNE
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9929 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-9404
Mailing Address - Country:US
Mailing Address - Phone:317-436-8961
Mailing Address - Fax:317-991-1593
Practice Address - Street 1:9929 E 126TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-9404
Practice Address - Country:US
Practice Address - Phone:317-436-8961
Practice Address - Fax:317-436-8966
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-16-24160103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst