Healthcare Provider Details

I. General information

NPI: 1023655909
Provider Name (Legal Business Name): KAYLA CHAUVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 COTTONWOOD SHORES DR
AUSTIN TX
78725-2940
US

IV. Provider business mailing address

2604 COTTONWOOD SHORES DR
AUSTIN TX
78725-2940
US

V. Phone/Fax

Practice location:
  • Phone: 512-337-9571
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: