Provider Demographics
NPI:1043928021
Name:ORILEY, KAYLA
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:ORILEY
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 1:3452 BARNHILL RD
Mailing Address - Street 2:
Mailing Address - City:GALIVANTS FERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29544-6697
Mailing Address - Country:US
Mailing Address - Phone:843-340-1335
Mailing Address - Fax:
Practice Address - Street 1:220 RONNIE CT STE 2
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4192
Practice Address - Country:US
Practice Address - Phone:843-945-0346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health