Healthcare Provider Details

I. General information

NPI: 1104551142
Provider Name (Legal Business Name): KAYLA SAFFOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 POE AVE STE 100
DAYTON OH
45414-2678
US

IV. Provider business mailing address

6640 POE AVE STE 100
DAYTON OH
45414-2678
US

V. Phone/Fax

Practice location:
  • Phone: 937-617-2273
  • Fax:
Mailing address:
  • Phone: 937-617-2273
  • Fax: 937-387-9987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2504754-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: