Provider Demographics
NPI:1013663269
Name:MCWHIRT, KAYLA ROSE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ROSE
Last Name:MCWHIRT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ROSE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4580 N COUNTY ROAD 0 EW
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-7862
Mailing Address - Country:US
Mailing Address - Phone:765-242-8109
Mailing Address - Fax:
Practice Address - Street 1:250 ALHAMBRA AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IN
Practice Address - Zip Code:46041-3164
Practice Address - Country:US
Practice Address - Phone:765-670-6300
Practice Address - Fax:765-670-6435
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-22-58219103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst