Michael Ryan Divine, BCBA

NPI #1033611181 in Clarksville, Tennessee

Provider Information

NPI Number
1033611181
Entity Type
Individual
Name
Michael Ryan Divine, BCBA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Behavior Analyst
Credential
BCBA
Enumeration Date
Mar 5, 2018
Last Updated
Sep 25, 2019

Practice Location

Address
3441 FORT CAMPBELL BLVD STE F3
ZIP Code
37042-6684
Phone
(931) 449-0063

Specialties & Taxonomy Codes

Specialty
Behavior Technician
Behavior Analyst

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