Provider Demographics
NPI:1063932804
Name:ROBBINS, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10087 E 580 RD
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-6205
Mailing Address - Country:US
Mailing Address - Phone:918-693-9792
Mailing Address - Fax:
Practice Address - Street 1:301 E OMAHA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1740
Practice Address - Country:US
Practice Address - Phone:918-259-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health