MEDICARE: DAIVLYNN HUMMER

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1669303962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAIVLYNN HUMMER

Provider Business Mailing Address
First Line	:	1298 EAGLES VIEW DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-2744
Country	:	US
Telephone Number	:	931-538-3252
Fax Number	:	931-538-3221

Provider Business Practice Location Address
First Line	:	1298 EAGLES VIEW DR
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37040-2744
Country	:	US
Telephone Number	:	931-538-3252
Fax Number	:	931-538-3221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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