Healthcare Provider Details

I. General information

NPI: 1174096341
Provider Name (Legal Business Name): KAYLA DANIELLE PACIFICI BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA DANILELLE FIELD

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E PRATT ST FL 8
BALTIMORE MD
21202-3180
US

IV. Provider business mailing address

1515 INDIAN RIVER BLVD STE A210
VERO BEACH FL
32960-7107
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46659
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-16-15911
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: