Healthcare Provider Details

I. General information

NPI: 1235048299
Provider Name (Legal Business Name): KRISTEN GABRIELLE SCHRADER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 WALNUT ST STE 150
CHATTANOOGA TN
37402-1314
US

IV. Provider business mailing address

8537 RICARDO LN
HIXSON TN
37343-1577
US

V. Phone/Fax

Practice location:
  • Phone: 423-553-5530
  • Fax:
Mailing address:
  • Phone: 423-664-2581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBCAB2752957
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: