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General NPI Number Information
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NPI Number | 1659008720
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Entity Type | Individual
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Provider Name | KAYLAH NICOLE DILLON CPC-I
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Gender | Female
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 09/04/2022
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Provider Practice Location Address
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Address Line | 3127 E WARM SPRINGS RD STE 300
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City | LAS VEGAS
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State | NV
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Zip | 89120-3134
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Country | US
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Telephone | 702-850-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 14808 WILLOW ROSE LANE
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City | ATHENS
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State | AL
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Zip | 35613
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C15147
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License Number State | NV
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