Provider Demographics
NPI:1477009660
Name:MARTEL, KAYLA MICHELLE (MED, LPC CANDIDATE)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MICHELLE
Last Name:MARTEL
Suffix:
Gender:F
Credentials:MED, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 NW 166TH TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6806
Mailing Address - Country:US
Mailing Address - Phone:405-640-4828
Mailing Address - Fax:
Practice Address - Street 1:307 E DANFORTH RD
Practice Address - Street 2:#124
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-4483
Practice Address - Country:US
Practice Address - Phone:405-726-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health