Provider Demographics
NPI:1558022814
Name:CALLENDER, KAILA (BCBA,LBA)
Entity Type:Individual
Prefix:
First Name:KAILA
Middle Name:
Last Name:CALLENDER
Suffix:
Gender:F
Credentials:BCBA,LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CHASE GAYTON CIR APT 1034
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23238-6538
Mailing Address - Country:US
Mailing Address - Phone:754-234-8658
Mailing Address - Fax:
Practice Address - Street 1:1107 ALVERSER DR.
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2655
Practice Address - Country:US
Practice Address - Phone:804-897-1793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002295103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst