Healthcare Provider Details

I. General information

NPI: 1801544630
Provider Name (Legal Business Name): KYLA NAYLENE HARVEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 PRIVATE ROAD 19423
SOUTH POINT OH
45680-8831
US

IV. Provider business mailing address

1404 RACE ST STE 302
CINCINNATI OH
45202-7366
US

V. Phone/Fax

Practice location:
  • Phone: 740-451-0741
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2202285
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: