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NPI Code Detail

MEDICARE: KAYLA N CORAZAO

MEDICARE: KAYLA N CORAZAO
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker111262TX

General Provider Information

NPI Number : 1205197969
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA N CORAZAO
Provider Business Mailing Address
First Line : 2025 HUNTER RD APT 8104
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78132-3157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 COVEMEADOW DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76012-5407
Country : US
Telephone Number : 931-684-0522
Fax Number : 931-684-6238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2012
Last Update Date : 09/08/2023

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Directions to “ KAYLA N CORAZAO ” Practice Location

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