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General NPI Number Information
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NPI Number | 1649667387
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Entity Type | Organization
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Legal Business Name | PEAK BEHAVIORAL STRATEGIES
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 107 HERMITAGE DR
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City | TULLAHOMA
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State | TN
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Zip | 37388-6201
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Country | US
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Telephone | 931-581-7397
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Fax |
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Provider Business Mailing Address
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Address Line | 107 HERMITAGE DR
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City | TULLAHOMA
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State | TN
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Zip | 37388-6201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, BEHAVIOR ANALYST
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Name | KIRBY ELLEN FITZGERALD
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Credential | M.A., BCBA
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Telephone | 931-581-7397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 11417342
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License Number State | TN
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