Individual
MRS. KAYLA NOELE PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2636 COUNTY ROAD 137, CARDINGTON, OH 43315-9530
(567) 231-8255
Mailing address
2636 COUNTY ROAD 137, CARDINGTON, OH 43315-9530
(567) 231-8255
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901108
—
OH
Enumeration date
12/30/2020
Last updated
12/30/2020
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