Individual
MOLLY ANN DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
131 HATCHER LN STE A, CLARKSVILLE, TN 37043-5921
(931) 444-1449
Mailing address
131 HATCHER LN STE A, CLARKSVILLE, TN 37043-5921
(931) 444-1449
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-16-20611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-23-63598
BACB
TN
01
—
RBT-16-20611
BACB
TN
Enumeration date
03/05/2018
Last updated
01/24/2023
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