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Individual

MRS. KAYLA ELAINE FAULKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
1700 E 38TH ST RM 222, MARION, IN 46953-4568
(765) 674-3321
Mailing address
1700 E 38TH ST RM 222, MARION, IN 46953-4568
(765) 674-3321

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33009728A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33009728A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
03/21/2022
Last updated
03/21/2022
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