Provider Demographics
NPI:1336995117
Name:GARDNER, KAYLA RENEE (LMSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:RENEE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:KS
Mailing Address - Zip Code:66512-0010
Mailing Address - Country:US
Mailing Address - Phone:785-217-8949
Mailing Address - Fax:
Practice Address - Street 1:216 PALMER ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:KS
Practice Address - Zip Code:66512-9591
Practice Address - Country:US
Practice Address - Phone:785-217-8949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker