Provider Demographics
NPI:1013745199
Name:KAYT WHITEBIRD ORANGE PHD
Entity type:Organization
Organization Name:KAYT WHITEBIRD ORANGE PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KAYT
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEBIRD ORANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-973-7417
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88355-1514
Mailing Address - Country:US
Mailing Address - Phone:575-973-7417
Mailing Address - Fax:
Practice Address - Street 1:305 MUSTANG DR
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-9155
Practice Address - Country:US
Practice Address - Phone:575-973-7417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service