Provider Demographics
NPI:1285352054
Name:DRESS, KAYLIE MARIE
Entity type:Individual
Prefix:
First Name:KAYLIE
Middle Name:MARIE
Last Name:DRESS
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 1:1382 BARBARA LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-1602
Mailing Address - Country:US
Mailing Address - Phone:419-566-2278
Mailing Address - Fax:
Practice Address - Street 1:222 MARION AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2138
Practice Address - Country:US
Practice Address - Phone:567-560-3582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator