Organization
EXEMPLARY BEHAVIOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE ANDERSON (CEO)
(615) 293-1864
Entity
Organization
Contact information
Practice address
4316 SUMMERCREST BLVD, SUITE, ANTIOCH, TN 37013-5805
(615) 293-1864
Mailing address
4316 SUMMERCREST BLVD, SUITE, ANTIOCH, TN 37013-5805
(615) 293-1864
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-04-1884
TN
Other
Enumeration date
11/22/2008
Last updated
11/22/2008
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