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NPI Code Detail

MEDICARE: KAYLA ROBERTS BCBA

MEDICARE: KAYLA ROBERTS BCBA
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
1103K00000XBehavior AnalystVA

General Provider Information

NPI Number : 1932617024
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ROBERTS BCBA
Provider Business Mailing Address
First Line : 1126 HOWBERT AVE SW
Second Line :
City : ROANOKE
State : VA
Zip : 24015-1716
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1700 WESTGATE DR STE 101
Second Line :
City : YORK
State : PA
Zip : 17408-6361
Country : US
Telephone Number : 888-726-4774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2018
Last Update Date : 02/07/2024

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