Healthcare Provider Details

I. General information

NPI: 1336846633
Provider Name (Legal Business Name): KYLI ERWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WALNUT ST STE 150
CHATTANOOGA TN
37402-1314
US

IV. Provider business mailing address

555 WALNUT ST STE 150
CHATTANOOGA TN
37402-1314
US

V. Phone/Fax

Practice location:
  • Phone: 423-703-9124
  • Fax: 833-708-7537
Mailing address:
  • Phone: 423-703-9124
  • Fax: 423-417-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2294
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: