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NPI Code Detail

MEDICARE: MS. ELIZABETH ANN GINDER MSSW, BCBA

MEDICARE: MS. ELIZABETH ANN GINDER MSSW, BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11-14-10123OTHERTNBACB
2LBA231OTHERTNSTATE OF TN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780087064
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH ANN GINDER MSSW, BCBA
Provider Business Mailing Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4720
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Provider Business Practice Location Address
First Line : 9038 CROSS PARK DR STE 105
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4720
Country : US
Telephone Number : 865-394-6612
Fax Number : 865-315-7014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 11/06/2020

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