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General NPI Number Information
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NPI Number | 1982475331
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Entity Type | Individual
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Provider Name | KYLA HOPKINS
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 709 W CENTENNIAL AVE
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City | CARTHAGE
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State | MO
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Zip | 64836-2816
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Country | US
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Telephone | 417-359-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 HILLDALE DR
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City | NEOSHO
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State | MO
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Zip | 64850-1358
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2019006178
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License Number State | MO
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