Healthcare Provider Details

I. General information

NPI: 1497649727
Provider Name (Legal Business Name): KAYLA RENEE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 EDEN WAY N STE E
CHESAPEAKE VA
23320-3339
US

IV. Provider business mailing address

6703 DICKENS CT W
SUFFOLK VA
23435-3072
US

V. Phone/Fax

Practice location:
  • Phone: 703-596-9332
  • Fax:
Mailing address:
  • Phone: 757-945-3995
  • Fax: 757-945-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: