Healthcare Provider Details

I. General information

NPI: 1558281063
Provider Name (Legal Business Name): INFINITY EARLY INTERVENTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 S ROAN ST
JOHNSON CITY TN
37601-5728
US

IV. Provider business mailing address

404 S ROAN ST
JOHNSON CITY TN
37601-5728
US

V. Phone/Fax

Practice location:
  • Phone: 423-922-5770
  • Fax:
Mailing address:
  • Phone: 423-922-5770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER L MULLINS
Title or Position: FOUNDER
Credential: BCBA
Phone: 423-922-5770