Provider Demographics
NPI:1477106276
Name:HOFFMAN, KAYLA ANN
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:MCCRITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 TULLISON RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2639
Mailing Address - Country:US
Mailing Address - Phone:785-608-8396
Mailing Address - Fax:
Practice Address - Street 1:5000 NW MONTEBELLA DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:MO
Practice Address - Zip Code:64150-7824
Practice Address - Country:US
Practice Address - Phone:785-608-8396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110033031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical