| Positive Vibes Aba, Llc | |
|
1657 E Stone Dr Ste B Kingsport TN 37660-4669 | |
| (423) 375-9192 | |
| Not Available |
| Full Name | Positive Vibes Aba, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1657 E Stone Dr Ste B, Kingsport, Tennessee |
| Authorized Official Name and Position | Melissa Cole (OWNER) |
| Authorized Official Contact | 4233759192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Vibes Aba, Llc 1657 E Stone Dr Ste B #151 Kingsport TN 37660-4669 Ph: (423) 375-9192 | Positive Vibes Aba, Llc 1657 E Stone Dr Ste B Kingsport TN 37660-4669 Ph: (423) 375-9192 |
| NPI Number | 1477027605 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 01/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477027605 | NPI | - | NPPES |
| Q045695 | Medicaid | TN | |
| Q034863 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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