Provider Demographics
NPI:1336945245
Name:VAIL, JAYDA LYNN (RBT)
Entity type:Individual
Prefix:
First Name:JAYDA
Middle Name:LYNN
Last Name:VAIL
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3625 OAKLAWN DR APT A
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-4928
Mailing Address - Country:US
Mailing Address - Phone:765-623-0253
Mailing Address - Fax:
Practice Address - Street 1:810 W 53RD ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-1516
Practice Address - Country:US
Practice Address - Phone:765-617-2279
Practice Address - Fax:765-274-5260
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-24-398057106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician