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NPI Code Detail

MEDICARE: KAYLA SCHMECK

MEDICARE:   KAYLA  SCHMECK
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ERP80165897303OTHERPACAPITAL BLUE CROSS

General Provider Information

NPI Number : 1619603867
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA SCHMECK
Provider Business Mailing Address
First Line : 3750 PHILEMON AVE APT 1406
Second Line :
City : CHARLOTTE
State : NC
Zip : 28206-2296
Country : US
Telephone Number : 570-380-0347
Fax Number :
Provider Business Practice Location Address
First Line : 3750 PHILEMON AVE APT 1406
Second Line :
City : CHARLOTTE
State : NC
Zip : 28206-2296
Country : US
Telephone Number : 570-380-0347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2022
Last Update Date : 07/29/2022

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Directions to “ KAYLA SCHMECK ” Practice Location

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