Provider Demographics
NPI:1528607751
Name:DAIKER, KYLEIGH DENISE (LGPC)
Entity type:Individual
Prefix:
First Name:KYLEIGH
Middle Name:DENISE
Last Name:DAIKER
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WALDON RD APT K
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2138
Mailing Address - Country:US
Mailing Address - Phone:443-807-9091
Mailing Address - Fax:
Practice Address - Street 1:1275B W PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4719
Practice Address - Country:US
Practice Address - Phone:410-996-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10045101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor