Provider Demographics
NPI:1386257392
Name:DROSCHA, KAYLA DANIELLE (MA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DANIELLE
Last Name:DROSCHA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:DANIELLE
Other - Last Name:GIBSON-BECKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1949
Mailing Address - Country:US
Mailing Address - Phone:517-588-1388
Mailing Address - Fax:
Practice Address - Street 1:2305 EAST PARIS AVE SE STE 203
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2426
Practice Address - Country:US
Practice Address - Phone:616-481-3784
Practice Address - Fax:866-496-2998
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health