Provider Demographics
NPI:1326606757
Name:NEEDHAM, KAYLA DEANN (CRT-SDS)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:DEANN
Last Name:NEEDHAM
Suffix:
Gender:
Credentials:CRT-SDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 FOREST GATE RD
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-9051
Mailing Address - Country:US
Mailing Address - Phone:662-660-3026
Mailing Address - Fax:
Practice Address - Street 1:1005 CITY AVE N
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-1414
Practice Address - Country:US
Practice Address - Phone:662-837-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSRCP3775227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified