Alissah Gulley

Individual provider Active NPI Behavior Technician · Mt Juliet, TN

NPI 1669242541 · NPPES record last updated Jan 3, 2024

Key facts

NPI
1669242541
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-256909 (TN)
Practice address
854 N Mount Juliet Rd
Mt Juliet, TN 37122-4430
Phone
(615) 558-4082
Fax
(317) 520-8200
NPI assigned
Jan 3, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RBT-23-256909TNMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-256909 TN Yes

Addresses

Primary practice location

854 N Mount Juliet Rd
Mt Juliet, TN 37122-4430

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other providers in Mt Juliet, TN

All providers in Mt Juliet, TN · Behavior Technician in Tennessee

Sources for this page

Verify at the official NPI Registry.