Healthcare Provider Details

I. General information

NPI: 1770446445
Provider Name (Legal Business Name): SAMANTHA BECHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6304 BRAMBLEWOOD DR
HIXSON TN
37343-2837
US

IV. Provider business mailing address

101 S ASTER AVE UNIT A
CHATTANOOGA TN
37419-1716
US

V. Phone/Fax

Practice location:
  • Phone: 563-260-5333
  • Fax:
Mailing address:
  • Phone: 815-582-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-396803
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: