Individual
KAYLA ELIZABETH BATES-BRANTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 BLACKJACK ROAD, MISSISSIPPI STATE, MS 39762-9727
(662) 325-0152
Mailing address
PO BOX 9727, MISSISSIPPI STATE, MS 39762-9727
(623) 253-4266
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
631161
MS
Other
Enumeration date
06/03/2015
Last updated
11/15/2023
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