Provider Demographics
NPI:1639960545
Name:CROWDER, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:CROWDER
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 1:1028 BALCH RD APT 1201
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9800
Mailing Address - Country:US
Mailing Address - Phone:334-740-0205
Mailing Address - Fax:
Practice Address - Street 1:805 MADISON ST SE STE 2E
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4424
Practice Address - Country:US
Practice Address - Phone:256-755-4278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician