Provider Demographics
NPI:1922574706
Name:HALE, KAYLA M
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:HALE
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 1:807 E WASHINGTON ST STE 150
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-3339
Mailing Address - Country:US
Mailing Address - Phone:330-241-4444
Mailing Address - Fax:
Practice Address - Street 1:807 E WASHINGTON ST STE 150
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-3339
Practice Address - Country:US
Practice Address - Phone:330-241-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator