Provider Demographics
NPI:1962996439
Name:NEELY, KYLA R (MSW)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:R
Last Name:NEELY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KYLA
Other - Middle Name:R
Other - Last Name:WARNSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2621 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-3880
Mailing Address - Country:US
Mailing Address - Phone:574-267-7169
Mailing Address - Fax:
Practice Address - Street 1:923 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-2678
Practice Address - Country:US
Practice Address - Phone:260-925-8035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker