Provider Demographics
NPI:1780221143
Name:JONES, KAYLA SUZANNE (RBT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:SUZANNE
Last Name:JONES
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 1:729 N GILL ST # A
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-7502
Mailing Address - Country:US
Mailing Address - Phone:910-501-9919
Mailing Address - Fax:
Practice Address - Street 1:4929 DARCY WOODS LN
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-7622
Practice Address - Country:US
Practice Address - Phone:919-810-1459
Practice Address - Fax:919-400-4224
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-19-107540106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician