Individual
JONATHAN TYLER HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
5203 MARYLAND WAY STE 104, BRENTWOOD, TN 37027-5022
(615) 560-6622
Mailing address
177 SUGAR CREEK RD, WEAVERVILLE, NC 28787-9665
(336) 402-6710
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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