MEDICARE: KAYLA HARDISON

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	103K00000X	Behavior Analyst	1-25-85024	FL
2	106S00000X	Behavior Technician	RBT-20-120011	FL
3	106E00000X	Assistant Behavior Analyst	0-22-13483	FL

General Provider Information

NPI Number	:	1740805480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA HARDISON

Provider Business Mailing Address
First Line	:	947 WELCH HILL CIR
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-2784
Country	:	US
Telephone Number	:	407-956-0090
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 N CLARA AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-4202
Country	:	US
Telephone Number	:	386-795-5695
Fax Number	:

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

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	01/20/2026

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Directions to “ KAYLA HARDISON ” Practice Location

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