MEDICARE: MRS. ELIZABETH JOANN BARNHILL

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	RBT-22-207907	TN
2	103K00000X	Behavior Analyst	1204	TN

General Provider Information

NPI Number	:	1679205769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH JOANN BARNHILL

Provider Business Mailing Address
First Line	:	136 STONE GATE CIR
Second Line	:
City	:	LOUDON
State	:	TN
Zip	:	37774-5668
Country	:	US
Telephone Number	:	731-589-1311
Fax Number	:

Provider Business Practice Location Address
First Line	:	8930 CROSS PARK DR STE 1
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4713
Country	:	US
Telephone Number	:	731-589-1311
Fax Number	:

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

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	02/27/2023

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