MEDICARE: KAYLAH PHILLIPS

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1497682264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLAH PHILLIPS

Provider Business Mailing Address
First Line	:	2601 JILLS TRL
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73012-4350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 S FRETZ AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-5532
Country	:	US
Telephone Number	:	405-757-7980
Fax Number	:

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

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ KAYLAH PHILLIPS ” Practice Location

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