MICHAEL RYAN DIVINE

CLARKSVILLE, TN
NPI1033611181
Former NameMICHAEL RYAN OLDFIELD
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103K00000X Behavior Analyst
Additional Taxonomies106S00000X Behavior Technician
(Licence: TN  RBT-16-17545)
Enumeration Date2018-03-05
Last Update Date2019-09-25
Business Address
MICHAEL RYAN DIVINE BCBA
3441 FORT CAMPBELL BLVD STE F3
CLARKSVILLE, TN 37042-6684
Phone number: 931-449-0063
Mailing Address
MICHAEL RYAN DIVINE BCBA
3441 FORT CAMPBELL BLVD STE F3
CLARKSVILLE, TN 37042-6684
Phone number: 931-449-0063