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Individual

KAYLA R WYNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
3441 FORT CAMPBELL BLVD STE F3, CLARKSVILLE, TN 37042-6684
(931) 449-0063
Mailing address
3441 FORT CAMPBELL BLVD STE F3, CLARKSVILLE, TN 37042-6684
(931) 449-0063

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-40961
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-20-40961
BEHAVIOR ANALYST CERTIFICATION BOARD (BACB)
TN
Enumeration date
03/05/2018
Last updated
04/01/2020
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