Healthcare Provider Details

I. General information

NPI: 1831053016
Provider Name (Legal Business Name): ADELINE AUTUMN BLESSING-LOGGINS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
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: 833-708-7537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-496845
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: