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General NPI Number Information
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NPI Number | 1710205117
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Entity Type | Individual
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Provider Name | KAYLA RENAE WHITWORTH LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 2305 DEL MAR CT
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City | DENTON
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State | TX
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Zip | 76210-3639
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Country | US
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Telephone | 940-453-1559
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 S CORINTH ST APT 4202
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City | CORINTH
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State | TX
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Zip | 76210-3706
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Country | US
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Telephone | 940-453-1559
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 50140
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License Number State | TX
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