Individual
MR. MAX EDWARD TICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
1114 CAREY CIR, LAWRENCEBURG, TN 38464-2974
(931) 629-0944
(931) 762-6532
Mailing address
1114 CAREY CIR, 1114 CAREY CIRCLE, LAWRENCEBURG, TN 38464-2974
(931) 629-0944
(931) 762-6532
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0000000064
TN
Other
Enumeration date
02/24/2008
Last updated
11/01/2019
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