Healthcare Provider Details

I. General information

NPI: 1053260356
Provider Name (Legal Business Name): MARKA DELAYNE PHILLIPS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 NIGGS CREEK RD
ONEIDA TN
37841-6417
US

IV. Provider business mailing address

1633 NIGGS CREEK RD
ONEIDA TN
37841-6417
US

V. Phone/Fax

Practice location:
  • Phone: 423-215-3044
  • Fax:
Mailing address:
  • Phone: 423-215-3044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2089
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: