Provider Demographics
NPI:1518622109
Name:HAIR, KAILEE SAMANTHA
Entity Type:Individual
Prefix:
First Name:KAILEE
Middle Name:SAMANTHA
Last Name:HAIR
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 1:305 CARDINAL LN
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-9735
Mailing Address - Country:US
Mailing Address - Phone:512-626-8033
Mailing Address - Fax:
Practice Address - Street 1:3300 N INTERSTATE 35 STE 700
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1874
Practice Address - Country:US
Practice Address - Phone:512-578-6741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician