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NPI Code Detail

MEDICARE: MCKINLEIGH GRACE GUTHRIE

MEDICARE: MCKINLEIGH GRACE GUTHRIE
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1366145310
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKINLEIGH GRACE GUTHRIE
Provider Business Mailing Address
First Line : 334 IRON WORKERS RD
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-7903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 IMPERIAL BLVD STE E
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-3400
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 03/27/2023

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Directions to “ MCKINLEIGH GRACE GUTHRIE ” Practice Location

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