Individual
KAYLA RENNE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12008 W US HIGHWAY 60, OLIVE HILL, KY 41164-8363
(270) 763-8225
Mailing address
12008 W US HIGHWAY 60, OLIVE HILL, KY 41164-8363
(270) 763-8225
(270) 283-4894
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
Primary
201172996
KY
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
05/22/2017
Last updated
01/24/2024
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