Provider Demographics
NPI:1780403840
Name:TAPP, KYLEE (MSW, PCMHT)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:TAPP
Suffix:
Gender:F
Credentials:MSW, PCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10B COUNTY ROAD 58
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MS
Mailing Address - Zip Code:38838-9520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1213 MARIA LN
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-1135
Practice Address - Country:US
Practice Address - Phone:662-423-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker