| Practical Behavior Analysis, Llc | |
|
2270 Thornton Taylor Pkwy Ste B Fayetteville TN 37334-3669 | |
| (954) 295-8448 | |
| Not Available |
| Full Name | Practical Behavior Analysis, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2270 Thornton Taylor Pkwy Ste B, Fayetteville, Tennessee |
| Authorized Official Name and Position | Zachary Stevens (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9542958448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Practical Behavior Analysis, Llc 2270 Thornton Taylor Pkwy Ste B Fayetteville TN 37334-3669 Ph: (615) 669-6397 | Practical Behavior Analysis, Llc 2270 Thornton Taylor Pkwy Ste B Fayetteville TN 37334-3669 Ph: (954) 295-8448 |
| NPI Number | 1184131633 |
|---|---|
| Provider Enumeration Date | 01/05/2018 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184131633 | NPI | - | NPPES |
| Q006469 | Medicaid | TN | |
| Q033196 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 11 (Tennessee) | Primary |
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