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NPI Code Detail

MEDICARE: KAYLEY KORINA LOR

MEDICARE: KAYLEY KORINA LOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1306599766
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEY KORINA LOR
Provider Business Mailing Address
First Line : 4575 SE DIXIE HWY
Second Line :
City : STUART
State : FL
Zip : 34997-6826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3628 26TH STREET DR NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-7206
Country : US
Telephone Number : 828-459-6003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2022
Last Update Date : 08/01/2024

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Directions to “ KAYLEY KORINA LOR ” Practice Location

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