Provider Demographics
NPI:1194289249
Name:ALVARADO, KAYLA NICHOLE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:NICHOLE
Last Name:ALVARADO
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 1:6336 THEDEN ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-8975
Mailing Address - Country:US
Mailing Address - Phone:913-575-9958
Mailing Address - Fax:
Practice Address - Street 1:7001 W 79TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3179
Practice Address - Country:US
Practice Address - Phone:816-802-6969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician