Provider Demographics
NPI:1760139125
Name:BARNHARDT, KAYLIN NAOMI
Entity Type:Individual
Prefix:
First Name:KAYLIN
Middle Name:NAOMI
Last Name:BARNHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 LEROY LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-4663
Mailing Address - Country:US
Mailing Address - Phone:817-962-9490
Mailing Address - Fax:
Practice Address - Street 1:2611 LEROY LN UNIT A
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-4663
Practice Address - Country:US
Practice Address - Phone:817-962-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2154339225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant