Healthcare Provider Details
I. General information
NPI: 1194326637
Provider Name (Legal Business Name): KAYLA WRIGHT COUNSELING, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/02/2020
Last Update Date: 11/02/2020
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1901 N MOORE AVE STE 15
MOORE OK
73160-3612
US
IV. Provider business mailing address
3139 SW 103RD ST
OKLAHOMA CITY OK
73159-6041
US
V. Phone/Fax
- Phone: 405-277-0482
- Fax:
- Phone: 405-837-6681
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KAYLA
RENEE
HIGNITE
Title or Position: LICENSED ALCOHOL, DRUG, AND MH
Credential: LADC/MH
Phone: 405-837-6681