Healthcare Provider Details

I. General information

NPI: 1528991197
Provider Name (Legal Business Name): KYLIE ROSE MEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PALMETTO PKWY STE 105
HILTON HEAD ISLAND SC
29926-3733
US

IV. Provider business mailing address

20 SIMMONSVILLE RD APT 1403
BLUFFTON SC
29910-5967
US

V. Phone/Fax

Practice location:
  • Phone: 843-405-0619
  • Fax:
Mailing address:
  • Phone: 412-477-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: