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NPI Code Detail

MEDICARE: KAYLA KANABLE M.S., BCBA

MEDICARE: KAYLA KANABLE M.S., BCBA
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
1103K00000XBehavior Analyst429-140WI
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1558826354
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA KANABLE M.S., BCBA
Provider Business Mailing Address
First Line : 34 CANYON LN
Second Line :
City : MCFARLAND
State : WI
Zip : 53558-8852
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 WHALEN RD
Second Line :
City : VERONA
State : WI
Zip : 53593-1765
Country : US
Telephone Number : 608-690-5999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2019
Last Update Date : 02/22/2023

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