Provider Demographics
NPI:1134570195
Name:CARR, KAYLA B (RBT)
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:B
Last Name:CARR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 DOLETTO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-7517
Mailing Address - Country:US
Mailing Address - Phone:702-243-3808
Mailing Address - Fax:
Practice Address - Street 1:616 DOLETTO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89138-7517
Practice Address - Country:US
Practice Address - Phone:702-243-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT 16-20807247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVRBT-16-20807OtherBACB