Individual
JENNA RENEE DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
2861 HIGHWAY 52 E, LAFAYETTE, TN 37083-6029
(615) 688-9504
(615) 688-9503
Mailing address
126 DOUBLEWIDE LN, LAFAYETTE, TN 37083-4243
(615) 388-6555
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-71035
TN
106S00000X
Behavior Technician
RBT-19-76844
TN
Other
Enumeration date
02/07/2019
Last updated
02/14/2024
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