Provider Demographics
NPI:1952865149
Name:CHILD DEVELOPMENT SERVICES OF MURFREESBORO
Entity Type:Organization
Organization Name:CHILD DEVELOPMENT SERVICES OF MURFREESBORO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:BCSB, LBA
Authorized Official - Phone:615-522-1336
Mailing Address - Street 1:118 EVENTIDE DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:947 PARK AVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4907
Practice Address - Country:US
Practice Address - Phone:615-522-1336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty