Provider Demographics
NPI:1932788676
Name:CLAYTON, MCKAYLA MORGAN (RBT)
Entity Type:Individual
Prefix:
First Name:MCKAYLA
Middle Name:MORGAN
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:MCKAYLA
Other - Middle Name:MORGAN
Other - Last Name:BAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 SAINT ANDREWS DR APT 24-205
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-3508
Mailing Address - Country:US
Mailing Address - Phone:256-508-2463
Mailing Address - Fax:
Practice Address - Street 1:401 S MOUNT JULIET RD STE 235-118
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-6359
Practice Address - Country:US
Practice Address - Phone:703-506-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNBACB647631106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician