Provider Demographics
NPI:1912326349
Name:KENDALL, KAYLA (LMT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:KENDALL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 2ND ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-8062
Mailing Address - Country:US
Mailing Address - Phone:740-350-0325
Mailing Address - Fax:
Practice Address - Street 1:310 GREENE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3133
Practice Address - Country:US
Practice Address - Phone:740-350-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2008-2477174400000X
OH33.017228174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist