Individual
AUTUMN ELLIS-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
240 CLEARLAKE DR W, NASHVILLE, TN 37217-4502
(615) 414-2193
Mailing address
240 CLEARLAKE DR W, NASHVILLE, TN 37217-4502
(615) 414-2193
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-440981
TN
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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