Provider Demographics
NPI:1023872264
Name:KAYLOR, AUTUMN L
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:L
Last Name:KAYLOR
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 1:11995 HILLCREST DR SW
Mailing Address - Street 2:
Mailing Address - City:MAUCKPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47142-9305
Mailing Address - Country:US
Mailing Address - Phone:812-267-4746
Mailing Address - Fax:
Practice Address - Street 1:535 COUNTRY CLUB RD SE
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-1705
Practice Address - Country:US
Practice Address - Phone:812-738-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker