Individual
KAYLA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7712 BANNOCKBURN TRL, COLORADO SPRINGS, CO 80908-4845
(832) 922-2414
Mailing address
7712 BANNOCKBURN TRL, COLORADO SPRINGS, CO 80908-4845
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
TX
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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