Individual
KAYLA HOLLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 N 5TH ST, LAFAYETTE, IN 47901-2811
(765) 423-7988
Mailing address
PO BOX 298, BROOK, IN 47922-0298
(219) 204-1434
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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