NPI 1104433630 · live from the CMS NPI Registry
Appalachian Pediatric Therapy, LLC
Behavior Analyst in Kingsport, TN. National Provider Identifier 1104433630, active.
NPI record
| NPI | 1104433630 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 5400 Fort Henry Dr Ste 12, Kingsport, TN 37663 |
| Practice phone | 423-426-3304 |
| Mailing address | 118 Patrick Henry Cir, Kingsport, TN 37663 |
| Enumerated | September 29, 2020 |
| Last updated | September 29, 2020 |
| Authorized official | Wendi Minutolo, Co-Owner/Lba |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.