Individual
MS. LAURA FORKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, BCBA-D
Contact information
Practice address
3131 QUIET CREEK TRL, CHATTANOOGA, TN 37406-4009
(423) 664-0901
(423) 602-9710
Mailing address
3131 QUIET CREEK TRL, CHATTANOOGA, TN 37406-4009
(423) 664-0901
(423) 602-9710
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508054
—
TN
Enumeration date
09/17/2008
Last updated
06/16/2015
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