Alissa Jean Vaughn, BEHAVIOR HEALTH

Individual provider Active NPI Behavior Technician · Byrdstown, TN

NPI 1902618705 · NPPES record last updated Jan 21, 2025

Key facts

NPI
1902618705
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
105 Taylor Dr
Byrdstown, TN 38549-2414
Phone
(931) 704-5155
NPI assigned
Jan 21, 2025
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X TN Yes

Addresses

Primary practice location

105 Taylor Dr
Byrdstown, TN 38549-2414

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727

Other identifiers

IdentifierTypeStateIssuer
1912670464MedicaidFL

Other providers in Byrdstown, TN

All providers in Byrdstown, TN · Behavior Technician in Tennessee

Sources for this page

Verify at the official NPI Registry.