Organization
WELLSPRING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY HALE PHD, BCBA, LBA (OWNER)
(615) 688-9504
Entity
Organization
Contact information
Practice address
300 FAIRLANE DR, LAFAYETTE, TN 37083-1709
(615) 688-9504
(615) 688-9503
Mailing address
300 FAIRLANE DR, LAFAYETTE, TN 37083-1709
(615) 688-9504
(615) 688-9503
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/21/2018
Last updated
10/25/2022
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