Provider Demographics
NPI:1558159665
Name:HANIFAN, KAYLA LANAE-ANN (RBT)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:LANAE-ANN
Last Name:HANIFAN
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:LANAE-ANN
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 CANE CREEK BLVD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5609
Practice Address - Country:US
Practice Address - Phone:704-824-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician