Provider Demographics
NPI:1336956762
Name:SCARBROUGH, KAILEY JANE
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:JANE
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 NEEDHAM DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-9612
Mailing Address - Country:US
Mailing Address - Phone:270-619-0650
Mailing Address - Fax:
Practice Address - Street 1:7146 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9585
Practice Address - Country:US
Practice Address - Phone:615-283-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-24-379010106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician