Provider Demographics
NPI:1588443097
Name:WARD, KYLARA LYNN (QMHA)
Entity type:Individual
Prefix:
First Name:KYLARA
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:KYLARA
Other - Middle Name:LYNN
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:QMHA
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:HEPPNER
Mailing Address - State:OR
Mailing Address - Zip Code:97836-0469
Mailing Address - Country:US
Mailing Address - Phone:541-676-9161
Mailing Address - Fax:541-697-6566
Practice Address - Street 1:435 E NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-2487
Practice Address - Country:US
Practice Address - Phone:541-564-9390
Practice Address - Fax:541-564-9384
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health