Provider Demographics
NPI:1598324659
Name:ROGOVER, KAYLA S (BCBA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:S
Last Name:ROGOVER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 CYPRESS PRESERVE DR APT 208
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6916
Mailing Address - Country:US
Mailing Address - Phone:954-802-2791
Mailing Address - Fax:
Practice Address - Street 1:1022 JONES RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0705
Practice Address - Country:US
Practice Address - Phone:479-318-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-50551103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst