Provider Demographics
NPI:1407245194
Name:KASSIR, KAYLA GRACE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:GRACE
Last Name:KASSIR
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 1:8250 E HARVARD AVE
Mailing Address - Street 2:APT 8311
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3990
Mailing Address - Country:US
Mailing Address - Phone:949-412-2863
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-18
Last Update Date:2015-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator