Individual
KAYLA O'NEILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4610 25TH ST, COLUMBUS, IN 47203-3239
(701) 238-9043
Mailing address
10043 N HICKORY LN, COLUMBUS, IN 47203-9764
(701) 238-9043
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
IN
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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