Individual
KYLA EILEEN IDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
327 E MILL ST, CIRCLEVILLE, OH 43113-2029
(740) 500-1402
Mailing address
110 HIGHLAND AVE, CIRCLEVILLE, OH 43113-1208
(740) 500-1402
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.190927
OH
101YM0800X
Mental Health Counselor
Primary
C.2607963
OH
Other
Enumeration date
06/21/2023
Last updated
04/07/2026
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