Individual
CLOVELLA GRACE BUTTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
334 BRYAN DR, DAYTON, TN 37321-6264
(423) 647-2137
Mailing address
334 BRYAN DR, DAYTON, TN 37321-6264
(423) 647-2137
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-292924
TN
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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