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General NPI Number Information
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NPI Number | 1598492571
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA BRAIN TRAIN
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 11/29/2023
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Provider Practice Location Address
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Address Line | 2040 HAMILTON PLACE BLVD STE 780
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6072
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Country | US
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Telephone | 423-305-1599
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Fax |
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Provider Business Mailing Address
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Address Line | 2040 HAMILTON PLACE BLVD STE 780
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6072
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Country | US
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Telephone | 423-305-1599
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MICHELLE HECKER DAVIS
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Credential | BCCS
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Telephone | 423-305-1599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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