Provider Demographics
NPI:1043579931
Name:BUTLER, KAYLA J (MS)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:J
Last Name:BUTLER
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 1:4317 SW 22ND ST APT 516
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73108-1915
Mailing Address - Country:US
Mailing Address - Phone:918-906-1633
Mailing Address - Fax:
Practice Address - Street 1:1209 SOVEREIGN ROW
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73108-1824
Practice Address - Country:US
Practice Address - Phone:405-942-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional