Healthcare Provider Details

I. General information

NPI: 1487521290
Provider Name (Legal Business Name): MS. CARRIAH BAYLARK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4721 S CLIFF AVE STE 103
INDEPENDENCE MO
64055-6969
US

IV. Provider business mailing address

4721 S CLIFF AVE STE 103
INDEPENDENCE MO
64055-6969
US

V. Phone/Fax

Practice location:
  • Phone: 816-831-1777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-339938
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: