Healthcare Provider Details

I. General information

NPI: 1306624895
Provider Name (Legal Business Name): MAKAYLA HUX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W JACKSON ST
SHELBYVILLE IN
46176-1295
US

IV. Provider business mailing address

418 W 17TH ST
CONNERSVILLE IN
47331-2211
US

V. Phone/Fax

Practice location:
  • Phone: 317-512-2101
  • Fax:
Mailing address:
  • Phone: 765-309-6567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: