Provider Demographics
NPI:1073293866
Name:STRAIT, MAKAYLA
Entity Type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:STRAIT
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 1:31730 BREEZY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DEER ISLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97054-9522
Mailing Address - Country:US
Mailing Address - Phone:916-233-5227
Mailing Address - Fax:
Practice Address - Street 1:31730 BREEZY RIDGE LN
Practice Address - Street 2:
Practice Address - City:DEER ISLAND
Practice Address - State:OR
Practice Address - Zip Code:97054-9522
Practice Address - Country:US
Practice Address - Phone:916-233-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician