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NPI Code Detail

MEDICARE: KAYLA ANN PENNIE LSW

MEDICARE: KAYLA ANN PENNIE LSW
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
11041C0700XClinical Social WorkerS.2512156OH

General Provider Information

NPI Number : 1366245771
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ANN PENNIE LSW
Provider Business Mailing Address
First Line : 17 W WATERBURY DR
Second Line :
City : SPRINGBORO
State : OH
Zip : 45066-8114
Country : US
Telephone Number : 937-479-1342
Fax Number :
Provider Business Practice Location Address
First Line : 10861 YANKEE ST
Second Line :
City : CENTERVILLE
State : OH
Zip : 45458-3574
Country : US
Telephone Number : 937-619-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2025
Last Update Date : 05/22/2025

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Directions to “ KAYLA ANN PENNIE LSW” Practice Location

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