Provider Demographics
NPI:1083392021
Name:BECTON, KAYLA DASHA
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DASHA
Last Name:BECTON
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 1:1320 S ST NW UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-7834
Mailing Address - Country:US
Mailing Address - Phone:202-368-2472
Mailing Address - Fax:
Practice Address - Street 1:1320 S ST NW UNIT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-7834
Practice Address - Country:US
Practice Address - Phone:202-368-2472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator