Individual
JOSHUA DYLAN LUCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6761 STAGE RD, BARTLETT, TN 38134-3867
(901) 379-8827
(901) 421-5187
Mailing address
6761 STAGE RD, BARTLETT, TN 38134-3867
(901) 379-8827
(901) 421-5187
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-56764
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-56764
RBT-18-56764
TN
Enumeration date
07/18/2018
Last updated
07/18/2018
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