Healthcare Provider Details

I. General information

NPI: 1992443899
Provider Name (Legal Business Name): INSPIRED ABA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2022
Last Update Date: 05/22/2022
Certification Date: 05/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 VICKSBURG RD
JOHNSON CITY TN
37604-6388
US

IV. Provider business mailing address

3004 VICKSBURG RD
JOHNSON CITY TN
37604-6388
US

V. Phone/Fax

Practice location:
  • Phone: 931-302-9723
  • Fax: 844-440-1982
Mailing address:
  • Phone: 931-302-9723
  • Fax: 844-440-1982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH SCHELLHAMMER
Title or Position: OWNER
Credential: BCBCA, LBA
Phone: 931-302-9723