Individual
PROSPERITY A DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
727 BELL RD APT 1016, ANTIOCH, TN 37013-8020
(901) 364-0167
Mailing address
727 BELL RD APT 1016, ANTIOCH, TN 37013-8020
(901) 364-0167
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
TN
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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