Healthcare Provider Details

I. General information

NPI: 1346378122
Provider Name (Legal Business Name): KYLAH ANN BARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 02/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 SKYWAY
PARADISE CA
95969-3280
US

IV. Provider business mailing address

7200 SKYWAY
PARADISE CA
95969-3280
US

V. Phone/Fax

Practice location:
  • Phone: 530-877-1965
  • Fax: 530-894-5791
Mailing address:
  • Phone: 530-877-1965
  • Fax: 530-894-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: