Provider Demographics
NPI:1942577945
Name:KYLE, JANICE MARIE
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:MARIE
Last Name:KYLE
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 1:3925 N MARTIN L KING BLVD
Mailing Address - Street 2:208
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7673
Mailing Address - Country:US
Mailing Address - Phone:702-580-1788
Mailing Address - Fax:702-490-6808
Practice Address - Street 1:3925 N MARTIN L KING BLVD
Practice Address - Street 2:208
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7673
Practice Address - Country:US
Practice Address - Phone:702-580-1788
Practice Address - Fax:702-490-6808
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst