Mikayla Ray Drago
Individual provider Active NPI Behavior Analyst · West Haven, UT
NPI 1831786417 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1831786417
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 14197740-2506 (UT)
- Practice address
- 3950 W 4100 S
West Haven, UT 84401-8815 - Phone
- (385) 446-0733
- NPI assigned
- Dec 29, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14197740-2506 | UT | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurobehavioral Center for Growth LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 14197740-2506 | UT | Yes |
Addresses
Primary practice location
3950 W 4100 S
West Haven, UT 84401-8815
Mailing address
3950 W 4100 S
West Haven, UT 84401-8815
Phone (385) 446-0733
Other names
- Mikayla Ray Lebow
Other providers in West Haven, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.