NPI Code Details Logo

NPI 1689528101

NPI 1689528101 : KENEA C THEUS : SMYRNA, TN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1689528101
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KENEA C THEUS
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/23/2026
-----------------------------------------------------
    Last Update Date     |    02/23/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    883 SEVEN OAKS BLVD STE 850 
-----------------------------------------------------
    City                 |    SMYRNA
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37167-6691
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    629-216-2007
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2961 S RUTHERFORD BLVD APT C1 
-----------------------------------------------------
    City                 |    MURFREESBORO
-----------------------------------------------------
    State                |    TN
-----------------------------------------------------
    Zip                  |    37130-6061
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    615-684-1776
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106S00000X
-----------------------------------------------------
    Taxonomy Name        |    Behavior Technician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    TN
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.