Provider Demographics
NPI:1104424308
Name:THRUSH, MAKAYLA
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:THRUSH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 WESTERLY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8594
Mailing Address - Country:US
Mailing Address - Phone:931-553-1395
Mailing Address - Fax:
Practice Address - Street 1:3031 WESTERLY DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8594
Practice Address - Country:US
Practice Address - Phone:615-663-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X
TN1-24-75279103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician