Provider Demographics
NPI:1194587246
Name:BARROS-MATHENEY, KAYLA TIA SARAE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:TIA SARAE
Last Name:BARROS-MATHENEY
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 1:210 N ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-4265
Mailing Address - Country:US
Mailing Address - Phone:541-810-9101
Mailing Address - Fax:
Practice Address - Street 1:3815 S 6TH ST STE 108
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4758
Practice Address - Country:US
Practice Address - Phone:541-205-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health