Healthcare Provider Details

I. General information

NPI: 1952919227
Provider Name (Legal Business Name): KAYLA MARIE BAYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 07/22/2020
Certification Date: 07/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 CROSS LANES DR
CROSS LANES WV
25313-1338
US

IV. Provider business mailing address

824 CROSS LANES DR
CROSS LANES WV
25313-1338
US

V. Phone/Fax

Practice location:
  • Phone: 304-759-9835
  • Fax: 304-759-9839
Mailing address:
  • Phone: 304-759-9835
  • Fax: 304-759-9839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberBP00945136
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: