Healthcare Provider Details

I. General information

NPI: 1932015575
Provider Name (Legal Business Name): KAYLA MANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 BRIARCLIFF RD NE
ATLANTA GA
30329-4010
US

IV. Provider business mailing address

440 FAIRFORD LN
JOHNS CREEK GA
30097-7839
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-9400
  • Fax:
Mailing address:
  • Phone: 770-842-3531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA003252
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: