Individual
TORI HANEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
(901) 666-8440
Mailing address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
(901) 666-8440
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
737
TN
106S00000X
Behavior Technician
RBT-18-51819
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-46933
BACB
TN
01
—
737
TN DEPARTMENT OF HEALTH
TN
Enumeration date
08/29/2018
Last updated
05/08/2024
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