Provider Demographics
NPI:1851186126
Name:PAYNE, MAKAILA JADE (RBT PENDING)
Entity type:Individual
Prefix:PROF
First Name:MAKAILA
Middle Name:JADE
Last Name:PAYNE
Suffix:
Gender:
Credentials:RBT PENDING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 ROSS CLARK CIR STE 1&2
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-4744
Mailing Address - Country:US
Mailing Address - Phone:334-446-4529
Mailing Address - Fax:334-446-4622
Practice Address - Street 1:1435 ROSS CLARK CIR STE 1&2
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-4744
Practice Address - Country:US
Practice Address - Phone:334-446-4529
Practice Address - Fax:334-446-4622
Is Sole Proprietor?:No
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician