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Individual

JOSEPH STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
182 OAK RD, NORRIS, TN 37828-3050
(865) 318-4020
Mailing address
PO BOX 364, NORRIS, TN 37828-0364
(865) 318-4020

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB522385

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BACB522385
BACB CERTIFICATION NUMBER
Enumeration date
02/01/2022
Last updated
02/01/2022
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