Healthcare Provider Details

I. General information

NPI: 1972476794
Provider Name (Legal Business Name): BRENNA ANNE MALONE B.S., RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 LANDRUM PL
CLARKSVILLE TN
37043-6319
US

IV. Provider business mailing address

331 LANDRUM PL
CLARKSVILLE TN
37043-6319
US

V. Phone/Fax

Practice location:
  • Phone: 931-553-1395
  • Fax: 931-553-1396
Mailing address:
  • Phone: 931-553-1395
  • Fax: 931-553-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: