Provider Demographics
NPI:1285423855
Name:CAGE, DAIJA TYANN (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:
First Name:DAIJA
Middle Name:TYANN
Last Name:CAGE
Suffix:
Gender:
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:
Other - First Name:DAIJA
Other - Middle Name:TYANN
Other - Last Name:CAGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:107 SINCLAIR WAY
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-3838
Mailing Address - Country:US
Mailing Address - Phone:912-401-1965
Mailing Address - Fax:
Practice Address - Street 1:131 CANAL ST
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-6018
Practice Address - Country:US
Practice Address - Phone:912-450-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GABACB93183106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABACB931383Medicaid