Provider Demographics
NPI:1144856725
Name:BURCH, TANEAL (BCBA)
Entity type:Individual
Prefix:
First Name:TANEAL
Middle Name:
Last Name:BURCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-5017
Mailing Address - Country:US
Mailing Address - Phone:423-648-1700
Mailing Address - Fax:
Practice Address - Street 1:880 W JACKSON ST STE E
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-7135
Practice Address - Country:US
Practice Address - Phone:931-287-3710
Practice Address - Fax:931-287-2778
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN566103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-19-40345OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD