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NPI Code Detail

MEDICARE: KAYLA PACIC MA

MEDICARE: KAYLA PACIC MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1073169553
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA PACIC MA
Provider Business Mailing Address
First Line : 4341 SUMMERLANE AVE NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-9507
Country : US
Telephone Number : 616-558-6837
Fax Number :
Provider Business Practice Location Address
First Line : 23100 JEFFERSON AVE
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48080-2756
Country : US
Telephone Number : 586-335-2006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 05/04/2023

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Directions to “ KAYLA PACIC MA” Practice Location

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