Provider Demographics
NPI:1033891338
Name:HAYWOOD, KAYDRA
Entity Type:Individual
Prefix:
First Name:KAYDRA
Middle Name:
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 BURKELAUN DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-3003
Mailing Address - Country:US
Mailing Address - Phone:334-303-5987
Mailing Address - Fax:
Practice Address - Street 1:3820 HARRISON RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-4508
Practice Address - Country:US
Practice Address - Phone:334-303-5987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6066G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker