Provider Demographics
NPI:1154787448
Name:RHEIN, KAYLA COLLINS (MED, BSL, BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:COLLINS
Last Name:RHEIN
Suffix:
Gender:F
Credentials:MED, BSL, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:LEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19533-8818
Mailing Address - Country:US
Mailing Address - Phone:610-451-6861
Mailing Address - Fax:
Practice Address - Street 1:149 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8818
Practice Address - Country:US
Practice Address - Phone:610-451-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-03
Last Update Date:2016-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-15-18262103K00000X
PABH002785103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst