Organization
QUSAYY M. GODBOLT
Active
Other names
Godbolt Behavioral Consulting
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA WALKER (ADMINISTRATOR)
(817) 938-0823
Entity
Organization
Contact information
Practice address
1207 SNOWBALL LN, CLARKSVILLE, TN 37042-7855
(931) 378-4751
Mailing address
1207 SNOWBALL LN, CLARKSVILLE, TN 37042-7855
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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