AMANDA MARIE LATTA (NPI# 1609480508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609480508 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE LATTA |
| Other Name | AMANDA MARIE WILLIS |
| Credential | RBT |
| Practice Address |
17390 Dugdale Dr Ste 100 South Bend IN 46635-1512 |
| Mailing Address |
3500 Depauw Blvd Ste 3070 Indianapolis IN 46268-6135 |
| Practice Telephone | 5744002169 |
| Practice Fax Number | 3175208200 |
| Mailing Telephone | 8553240885 |
| Mailing Fax Number | 3175208200 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-20-130980 | IN | Behavioral Health & Social Service Providers |
| Street Address |
17390 DUGDALE DR STE 100 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568915692 | Jessica Leeann Rimes | Behavioral Analyst | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2016-07-25 |
| 1942807953 | Faith Marisa Spiteri | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-10-02 |
| 1205443694 | Jesus Lozano | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-29 |
| 1457968505 | Mychaela Mychelle Winston | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-23 |
| 1689288839 | Haley Rose Traxler | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1215541461 | Trenton Anthony Adair | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1396359543 | Ieshia Maxine Mason | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1518571835 | Aylin Saray Arriaga | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-03 |
| 1851905160 | Haley Rose Wigfall | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-03 |
| 1831703230 | Chloe Bryeann Hossa | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871059824 | Delainey Kinney | Behavior Technician | 1308 Sunnymede Ave, South Bend, IN 46615-1018 | 2019-02-14 |
| 1942807953 | Faith Marisa Spiteri | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-10-02 |
| 1205443694 | Jesus Lozano | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-29 |
| 1457968505 | Mychaela Mychelle Winston | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-23 |
| 1689288839 | Haley Rose Traxler | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1215541461 | Trenton Anthony Adair | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1396359543 | Ieshia Maxine Mason | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-04 |
| 1518571835 | Aylin Saray Arriaga | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-03 |
| 1851905160 | Haley Rose Wigfall | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-03 |
| 1831703230 | Chloe Bryeann Hossa | Behavior Technician | 17390 Dugdale Dr Ste 100, South Bend, IN 46635-1512 | 2020-09-02 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
Please comment or provide details below to improve the information on AMANDA MARIE LATTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.