Provider Demographics
NPI:1023561362
Name:PICKARSKI, KAYLA CRYSTAL (MS)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:CRYSTAL
Last Name:PICKARSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14911 SW 104TH ST APT 12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2468
Mailing Address - Country:US
Mailing Address - Phone:786-663-0138
Mailing Address - Fax:
Practice Address - Street 1:8180 NW 36TH ST STE 404
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6674
Practice Address - Country:US
Practice Address - Phone:786-663-0138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor