Healthcare Provider Details

I. General information

NPI: 1457604282
Provider Name (Legal Business Name): KAYLA RAE HADD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 LAKEMARY DR
PAOLA KS
66071-1855
US

IV. Provider business mailing address

100 LAKEMARY DR
PAOLA KS
66071-1855
US

V. Phone/Fax

Practice location:
  • Phone: 913-557-4000
  • Fax: 913-557-4910
Mailing address:
  • Phone: 913-557-4000
  • Fax: 913-557-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7868
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: