Provider Demographics
NPI:1053065698
Name:SPIOTTI, MAKAILA
Entity Type:Individual
Prefix:
First Name:MAKAILA
Middle Name:
Last Name:SPIOTTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 N WALNUT CREEK PKWY APT G
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4622
Mailing Address - Country:US
Mailing Address - Phone:910-853-2337
Mailing Address - Fax:
Practice Address - Street 1:3171 N WALNUT CREEK PKWY APT G
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-4622
Practice Address - Country:US
Practice Address - Phone:910-853-2337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician