Provider Demographics
NPI:1588275341
Name:O'BRIEN, KAYLA E (BA, RP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:BA, RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 S HOWES ST APT 7
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2824
Mailing Address - Country:US
Mailing Address - Phone:518-708-9992
Mailing Address - Fax:
Practice Address - Street 1:710 11TH AVE # I46
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-6405
Practice Address - Country:US
Practice Address - Phone:518-708-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health