Provider Demographics
NPI:1285191866
Name:FARRIS, KAYLA (RCSW-I)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:FARRIS
Suffix:
Gender:F
Credentials:RCSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLTON
Mailing Address - State:FL
Mailing Address - Zip Code:32426-6827
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5601 HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:CAMPBELLTON
Practice Address - State:FL
Practice Address - Zip Code:32426-6827
Practice Address - Country:US
Practice Address - Phone:850-693-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical