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General NPI Number Information
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NPI Number | 1831867910
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Entity Type | Individual
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Provider Name | KAYLA SUE MINES PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 727-744-9456
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Fax |
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Provider Business Mailing Address
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Address Line | 15512 W 113TH ST
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City | LENEXA
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State | KS
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Zip | 66219-5100
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Country | US
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Telephone | 816-861-4700
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY11261
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License Number State | FL
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