Provider Demographics
NPI:1376147009
Name:SIMMONS, KAYLA MICHELLE (OMP, LMT, RYT(200))
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MICHELLE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:OMP, LMT, RYT(200)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1195 TRANTER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3037
Mailing Address - Country:US
Mailing Address - Phone:412-439-2281
Mailing Address - Fax:
Practice Address - Street 1:1195 TRANTER AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3037
Practice Address - Country:US
Practice Address - Phone:412-439-2281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOMP000268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist