Individual
DR. QUSAYY M GODBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, BCBA-D
Contact information
Practice address
1207 SNOWBALL LN, CLARKSVILLE, TN 37042-7855
(931) 378-4751
Mailing address
1207 SNOWBALL LN, CLARKSVILLE, TN 37042-7855
(931) 378-4751
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-09-5273
FL
103K00000X
Behavior Analyst
1-09-5273
KY
103K00000X
Behavior Analyst
1-09-5273
MO
103K00000X
Behavior Analyst
1-09-5273
TN
103K00000X
Behavior Analyst
Primary
1-09-5273
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100405480
—
KY
05
—
Q024708
—
TN
Enumeration date
03/24/2010
Last updated
03/20/2023
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