Provider Demographics
NPI:1780135731
Name:ROST, TAMERA (MA,BCBA)
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:ROST
Suffix:
Gender:F
Credentials:MA,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 SHALLOWFORD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7201
Mailing Address - Country:US
Mailing Address - Phone:423-531-7497
Mailing Address - Fax:888-678-4220
Practice Address - Street 1:6116 SHALLOWFORD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7201
Practice Address - Country:US
Practice Address - Phone:423-531-7497
Practice Address - Fax:888-678-4220
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-15-19128103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst