Most Relevant Information
Provider Data
| NPI Number: | 1003641697 |
| Provider Name: | CHASTITY JEFFERSON RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-24-360875 |
Most Important Dates
| Enumeration Date: | 09/04/2024 |
| Last Updated: | 09/04/2024 |
Provider Practice Location
2233 LYNNFIELD RD BLDG B
MEMPHIS
TN
381197238
Practice Location Phone/Fax
| Phone: | 9015868606 |
| Fax: | 3175208200 |
Provider Mailing Location
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS
IN
462686135
Provider Mailing Phone/Fax
| Phone: | 8553240885 |
| Fax: | 3175208200 |