Healthcare Provider Details

I. General information

NPI: 1093620635
Provider Name (Legal Business Name): KAYLA HAYDEN LARIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 THOMPSON DR
ABINGDON VA
24210-2346
US

IV. Provider business mailing address

812 THOMPSON DR
ABINGDON VA
24210-2346
US

V. Phone/Fax

Practice location:
  • Phone: 276-739-3922
  • Fax:
Mailing address:
  • Phone: 276-739-3922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133005328
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: