Provider Demographics
NPI:1689175358
Name:OPPERMAN, KAYLA (RBT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:OPPERMAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W GRANT ST APT 3050
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3968
Mailing Address - Country:US
Mailing Address - Phone:813-927-0361
Mailing Address - Fax:
Practice Address - Street 1:644 FERGUSON DR STE 200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1023
Practice Address - Country:US
Practice Address - Phone:407-574-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician