Healthcare Provider Details

I. General information

NPI: 1881401511
Provider Name (Legal Business Name): KAYLEY SCHWAB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2024
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 ANDERSON AVE
DREXEL HILL PA
19026-4303
US

IV. Provider business mailing address

721 ANDERSON AVE
DREXEL HILL PA
19026-4303
US

V. Phone/Fax

Practice location:
  • Phone: 912-406-2962
  • Fax:
Mailing address:
  • Phone: 912-406-2962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: