| Changing The Criterion Aba | |
|
2830 Austin Peay Hwy Ste 9 Memphis TN 38128-5627 | |
| (901) 503-6170 | |
| Not Available |
| Full Name | Changing The Criterion Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2830 Austin Peay Hwy Ste 9, Memphis, Tennessee |
| Authorized Official Name and Position | Jojuan Fullwiley (OWNER) |
| Authorized Official Contact | 9015036170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Changing The Criterion Aba 2830 Austin Peay Hwy Ste 9 Memphis TN 38128-5627 Ph: () - | Changing The Criterion Aba 2830 Austin Peay Hwy Ste 9 Memphis TN 38128-5627 Ph: (901) 503-6170 |
| NPI Number | 1598447849 |
|---|---|
| Provider Enumeration Date | 08/07/2023 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598447849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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