Individual
KAYLA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3727 EXECUTIVE CENTER DR, AUGUSTA, GA 30907-2398
(706) 842-5330
(706) 842-5340
Mailing address
3736 EXECUTIVE CENTER DR, AUGUSTA, GA 30907-2360
(706) 842-5330
(706) 842-5340
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46619
SC
106E00000X
Assistant Behavior Analyst
0-20-11286
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-20-11286
BACB
—
01
—
1-20-46619
BACB
SC
Enumeration date
08/18/2020
Last updated
07/13/2021
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