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Individual

THERESA A BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCABA, LABA

Contact information

Practice address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4720
(865) 394-6612
(865) 315-7014
Mailing address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4720
(865) 394-6612
(865) 315-7014

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
LABA36
TN
106S00000X
Behavior Technician
RBT-20-111054
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0-22-13918
BACB
TN
01
RBT-20-111054
BACB
TN
Enumeration date
02/11/2020
Last updated
12/29/2022
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