=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467321786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RURAL APPALACHIAN CONNECTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2025
-----------------------------------------------------
Last Update Date | 11/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 533 TAYLOR ACUFF RD
-----------------------------------------------------
City | WASHBURN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37888-4471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-259-1296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 533 TAYLOR ACUFF RD
-----------------------------------------------------
City | WASHBURN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37888-4471
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-259-1296
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BEHAVIOR ANALYST
-----------------------------------------------------
Name | KENDRA HADLEY
-----------------------------------------------------
Credential | BCBA, LBA
-----------------------------------------------------
Telephone | 423-259-1296
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------