Provider Demographics
NPI:1851903017
Name:AYERS, KAYLA DAWN (RBT)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:DAWN
Last Name:AYERS
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 1:3335 LT MOSS RD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-7222
Mailing Address - Country:US
Mailing Address - Phone:406-549-6413
Mailing Address - Fax:
Practice Address - Street 1:1725 MT HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2464
Practice Address - Country:US
Practice Address - Phone:406-755-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-17-35537106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTRBT-19-97796OtherBEHAVIOR ANALYST CERTIFICATION BOARD
MTRBT-19-97796OtherBEHAVIOR ANALYST CERTIFICATION BOARD