Healthcare Provider Details

I. General information

NPI: 1710899745
Provider Name (Legal Business Name): KAYLA AALIYAH BALDWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

7070 SAMUEL MORSE DR
COLUMBIA MD
21046-3405
US

IV. Provider business mailing address

5344 BROOK WAY APT 2
COLUMBIA MD
21044-1635
US

V. Phone/Fax

Practice location:
  • Phone: 410-309-4600
  • Fax:
Mailing address:
  • Phone: 240-762-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberNA
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: