Provider Demographics
NPI:1699228197
Name:EDSON, KAYLA (MA)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:EDSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:KONIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:4689 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3218
Mailing Address - Country:US
Mailing Address - Phone:970-831-3657
Mailing Address - Fax:
Practice Address - Street 1:4689 W 20TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3218
Practice Address - Country:US
Practice Address - Phone:970-834-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional