Individual
KAYLA MICHELLE FOMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OMT
Contact information
Practice address
136 HOMEPLACE DR, MT HOLLY, NC 28120-9660
(803) 820-1607
Mailing address
136 HOMEPLACE DR, MT HOLLY, NC 28120-9660
(803) 820-1607
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
11570
NC
171400000X
Health & Wellness Coach
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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