Provider Demographics
NPI:1598884132
Name:HABERL, KAYLA J (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:J
Last Name:HABERL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 JEWEL CIR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8486
Mailing Address - Country:US
Mailing Address - Phone:314-330-3879
Mailing Address - Fax:
Practice Address - Street 1:2213 GRAND AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5305
Practice Address - Country:US
Practice Address - Phone:515-237-3974
Practice Address - Fax:515-883-2692
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist