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NPI 1710450564

NPI 1710450564 : TAMMY LYNN DAVIS BCBA, LBA : CLEVELAND, TN

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General NPI Number Information
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    NPI Number           |    1710450564
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    Entity Type          |    Individual 
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    Provider Name        |    TAMMY LYNN DAVIS BCBA, LBA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/04/2019
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    Last Update Date     |    01/04/2019
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Provider Practice Location Address
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    Address Line         |    764 OLD CHATTANOOGA PIKE SW 
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    City                 |    CLEVELAND
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    State                |    TN
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    Zip                  |    37311-8566
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    Country              |    US
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    Telephone            |    423-472-5268
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    150 KING ARTHUR CT NW 
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    City                 |    CLEVELAND
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    State                |    TN
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    Zip                  |    37312-7106
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    Country              |    US
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    Telephone            |    423-303-9955
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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       |    
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    License Number State |    TN
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