Healthcare Provider Details

I. General information

NPI: 1326985201
Provider Name (Legal Business Name): KAYLA OSWALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA MARCOUX

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 COUNTY ROAD B2 W
LITTLE CANADA MN
55117-1402
US

IV. Provider business mailing address

2540 COUNTY ROAD F E
WHITE BEAR LAKE MN
55110-3935
US

V. Phone/Fax

Practice location:
  • Phone: 651-415-5383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28243
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: