Individual
DUSTIN WAYNE MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS; RBT
Contact information
Practice address
724 BARRETT BLVD STE A, HENDERSON, KY 42420-4931
(270) 702-4641
(615) 577-5654
Mailing address
1321 MURFREESBORO PIKE STE 702, NASHVILLE, TN 37217-2679
(844) 359-7629
(615) 577-5654
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-32549
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-32549
RBT CERTIFICATE
—
Enumeration date
04/08/2019
Last updated
11/19/2020
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