Individual
TAWNY MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
560 TRINITY CREEK CV, CORDOVA, TN 38018-2279
(901) 218-5527
(901) 249-5686
Mailing address
560 TRINITY CREEK CV, CORDOVA, TN 38018-2279
(901) 218-5527
(901) 249-5686
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-61310
TN
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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