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General NPI Number Information
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NPI Number | 1215671607
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Entity Type | Individual
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Provider Name | JAMILLA DISU
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Gender | Female
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Dates
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Enumeration Date | 04/22/2022
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 1526 HUNT CLUB BLVD UNIT 550
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City | GALLATIN
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State | TN
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Zip | 37066-6194
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Country | US
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Telephone | 615-426-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 HUNT CLUB BLVD UNIT 550
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City | GALLATIN
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State | TN
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Zip | 37066-6194
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Country | US
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Telephone | 615-426-0012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1973
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License Number State | TN
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