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General NPI Number Information
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NPI Number | 1225764434
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Entity Type | Individual
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Provider Name | KAIYA ALEXANDRA ROLLIN
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 320 12TH AVE NE
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City | NORMAN
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State | OK
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Zip | 73071-5238
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Country | US
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Telephone | 54-573-3819
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Fax | 405-701-6683
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Provider Business Mailing Address
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Address Line | 2801 WASHINGTON DR
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City | NORMAN
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State | OK
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Zip | 73069-1028
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Country | US
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Telephone | 405-561-5512
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OK
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