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NPI Code Detail

MEDICARE: MS. JULIE M ADCOCK BCBA, LBA

MEDICARE: MS. JULIE M ADCOCK BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1255596961
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE M ADCOCK BCBA, LBA
Provider Business Mailing Address
First Line : 331 LANDRUM PL
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-6329
Country : US
Telephone Number : 931-553-1395
Fax Number : 931-553-1396
Provider Business Practice Location Address
First Line : 331 LANDRUM PL
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-6329
Country : US
Telephone Number : 931-553-1395
Fax Number : 931-553-1396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2008
Last Update Date : 10/14/2020

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