Provider Demographics
NPI:1548984701
Name:WILLA TREE CONNECTIONS, PLLC
Entity type:Organization
Organization Name:WILLA TREE CONNECTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURKS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA, LBA
Authorized Official - Phone:931-208-2910
Mailing Address - Street 1:PO BOX 77
Mailing Address - Street 2:
Mailing Address - City:SMARTT
Mailing Address - State:TN
Mailing Address - Zip Code:37378-0077
Mailing Address - Country:US
Mailing Address - Phone:931-208-2910
Mailing Address - Fax:
Practice Address - Street 1:100 CENTER ST STE B
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2173
Practice Address - Country:US
Practice Address - Phone:931-208-2910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty