Individual
KAYLA EMILY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
859 S YELLOWSTONE HWY STE 202, REXBURG, ID 83440-5294
(307) 257-5487
Mailing address
PO BOX 20310, UNIT #55984, CHEYENNE, WY 82003-7007
(307) 257-5487
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
03/08/2023
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