| Creative Minds Behavior Services, Llc | |
|
4636 Lebanon Pike # 167 Hermitage TN 37076-1316 | |
| (615) 513-7183 | |
| (615) 777-3210 |
| Full Name | Creative Minds Behavior Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4636 Lebanon Pike # 167, Hermitage, Tennessee |
| Authorized Official Name and Position | Rasoul Mokhtari (BEHAVIOR ANALYST) |
| Authorized Official Contact | 6155137183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Minds Behavior Services, Llc 4636 Lebanon Pike # 167 Hermitage TN 37076-1316 Ph: (615) 513-7183 | Creative Minds Behavior Services, Llc 4636 Lebanon Pike # 167 Hermitage TN 37076-1316 Ph: (615) 513-7183 |
| NPI Number | 1831574565 |
|---|---|
| Provider Enumeration Date | 07/23/2015 |
| Last Update Date | 07/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831574565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-07-3620 (* (Not Available)) | Primary |
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