Individual
JENNA BAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA, BCBA, RBT
Contact information
Practice address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
(901) 666-8440
Mailing address
6413 QUINCE RD, MEMPHIS, TN 38119-8219
(901) 690-5213
(901) 666-8440
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
928
TN
106S00000X
Behavior Technician
RBT-21-171312
TN
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
928
DEPARTMENT OF HEALTH LICENSURE TN
TN
01
—
RBT-21-171312
BACB
TN
Enumeration date
06/08/2021
Last updated
03/11/2022
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