Kylah McDivitt
Individual provider Active NPI Behavior Technician · Bruceton, TN
NPI 1992623052 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1992623052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 29639 Broad St
Bruceton, TN 38317-2203 - Phone
- (925) 727-3712
- NPI assigned
- Jul 7, 2026
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
29639 Broad St
Bruceton, TN 38317-2203
Mailing address
3415 Bataan Memorial W
Las Cruces, NM 88012-5012
Phone (505) 392-3482
Other providers in Bruceton, TN
- Kylee Loveless
- Maleah Phipps
- Gavin Marcial
- Danielle Mason
- Jennifer McAdams
- Mary McFarlin
- Michelle McGee
- McKenzie Medical Center PC
- Macy McNabb
- Jasmine Melton
All providers in Bruceton, TN · Behavior Technician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. 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.