Provider Demographics
NPI:1568649770
Name:CHITTUM, WILLIAM ROBERT (MS, BCBA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:CHITTUM
Suffix:
Gender:M
Credentials:MS, BCBA
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Mailing Address - Street 1:249 OLIVER EDWARDS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-6537
Mailing Address - Country:US
Mailing Address - Phone:423-341-6963
Mailing Address - Fax:423-753-6963
Practice Address - Street 1:249 OLIVER EDWARDS RD
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-6537
Practice Address - Country:US
Practice Address - Phone:423-341-6963
Practice Address - Fax:423-753-6963
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst