Provider Demographics
NPI:1750017984
Name:WELCH, KAYLA (BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 ELMA RD
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:NE
Mailing Address - Zip Code:68030-3018
Mailing Address - Country:US
Mailing Address - Phone:712-899-2167
Mailing Address - Fax:
Practice Address - Street 1:2001 HAMILTON BLVD STE D
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-4142
Practice Address - Country:US
Practice Address - Phone:712-746-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst