MEDICARE: MISS KAYLEIGH L TORRES

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
1	101Y00000X	Counselor	141697	OH

General Provider Information

NPI Number	:	1275085383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KAYLEIGH L TORRES

Provider Business Mailing Address
First Line	:	4657 WOODHURST DR APT 4
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44515-3753
Country	:	US
Telephone Number	:	330-469-9743
Fax Number	:	330-300-6691

Provider Business Practice Location Address
First Line	:	5760 PATRIOT BLVD
Second Line	:
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515-1170
Country	:	US
Telephone Number	:	330-953-0243
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2016
Last Update Date	:	05/17/2021

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