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Individual

AMANDA FAITH MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4729
(865) 394-6612
(865) 315-7014
Mailing address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4729
(865) 394-6612
(865) 315-7014

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA1362
TN
106S00000X
Behavior Technician
RBT-19-76063
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-23-67973
BACB
TN
01
RBT-19-76063
BACB
TN
Enumeration date
11/05/2021
Last updated
11/02/2023
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