Individual
CODY ALEXANDER MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
120 HUXLEY RD STE 102, KNOXVILLE, TN 37922-3188
(865) 399-8885
Mailing address
1034 WOODVIEW LN, KNOXVILLE, TN 37909-3126
(865) 214-7914
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-176166
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85-1224409
—
TN
Enumeration date
07/15/2021
Last updated
07/15/2021
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