Provider Demographics
NPI:1760127070
Name:NITKA, KAYLA (BCBA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:NITKA
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 1:1810 COUNTY LINE RD STE 414
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1723
Mailing Address - Country:US
Mailing Address - Phone:267-388-0670
Mailing Address - Fax:267-348-4489
Practice Address - Street 1:1810 COUNTY LINE RD STE 414
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1723
Practice Address - Country:US
Practice Address - Phone:267-388-0670
Practice Address - Fax:267-348-4489
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA12258889103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12258889OtherBCBA