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General NPI Number Information
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NPI Number | 1083036859
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Entity Type | Organization
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Legal Business Name | KNOXVILLE CENTER FOR AUTISM, INC.
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 9051 EXECUTIVE PARK DR SUITE 200
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City | KNOXVILLE
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State | TN
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Zip | 37923-4606
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Country | US
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Telephone | 865-200-5127
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Fax | 865-200-5127
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Provider Business Mailing Address
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Address Line | 9051 EXECUTIVE PARK DR SUITE 200
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City | KNOXVILLE
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State | TN
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Zip | 37923-4606
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Country | US
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Telephone | 865-200-5127
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Fax | 865-200-5127
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | SARA L GILBERT
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Credential | M.S. BCBA
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Telephone | 865-200-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 5189
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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