=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205707379
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAYLA MILTON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2025
-----------------------------------------------------
Last Update Date | 09/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1526 HUNT CLUB BLVD UNIT 550
-----------------------------------------------------
City | GALLATIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37066-6194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-522-2467
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 133 WYNBROOKE TRCE
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37075-6715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-500-3736
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | BACB1280695
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------