Healthcare Provider Details

I. General information

NPI: 1205707379
Provider Name (Legal Business Name): JAYLA MILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 HUNT CLUB BLVD UNIT 550
GALLATIN TN
37066-6194
US

IV. Provider business mailing address

133 WYNBROOKE TRCE
HENDERSONVILLE TN
37075-6715
US

V. Phone/Fax

Practice location:
  • Phone: 866-522-2467
  • Fax:
Mailing address:
  • Phone: 725-500-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1280695
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: