Provider Demographics
NPI:1902012768
Name:MOTES, DAVID LANIER (BCBA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LANIER
Last Name:MOTES
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 DARTMOORE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-7428
Mailing Address - Country:US
Mailing Address - Phone:706-988-5512
Mailing Address - Fax:
Practice Address - Street 1:136 DARTMOORE DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-7428
Practice Address - Country:US
Practice Address - Phone:706-988-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100331103K00000X
171400000X, 174H00000X
TNLBA0000000096103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator