| Amaze Behavior Therapy | |
|
3505 Adkisson Dr Nw Suite 208 Cleveland TN 37312-6803 | |
| (423) 322-8796 | |
| (423) 473-6721 |
| Full Name | Amaze Behavior Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3505 Adkisson Dr Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Carrie Eileen Walls (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 4233228796 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amaze Behavior Therapy 3505 Adkisson Dr Nw Suite 208 Cleveland TN 37312-6803 Ph: (423) 322-8796 | Amaze Behavior Therapy 3505 Adkisson Dr Nw Suite 208 Cleveland TN 37312-6803 Ph: (423) 322-8796 |
| NPI Number | 1619379542 |
|---|---|
| Provider Enumeration Date | 09/23/2014 |
| Last Update Date | 09/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619379542 | NPI | - | NPPES |
| 1528677 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-12-11707 (Tennessee) | Primary |
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