Individual
MS. MALLORY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA, BCBA
Contact information
Practice address
401 S MOUNT JULIET RD STE 235-118, MT JULIET, TN 37122-6359
(615) 393-1709
Mailing address
1426B STAINBACK AVE, NASHVILLE, TN 37207-5134
(615) 310-6527
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
236
TN
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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