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NPI Code Detail

MEDICARE: MIKAYLA WORTHINGTON

MEDICARE: MIKAYLA WORTHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst2141TN

General Provider Information

NPI Number : 1568317410
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA WORTHINGTON
Provider Business Mailing Address
First Line : 1101 CARTER ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-5017
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1101 CARTER ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-5017
Country : US
Telephone Number : 423-648-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ MIKAYLA WORTHINGTON ” Practice Location

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