Individual
KAYLA PRIOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
254 W MAIN ST, UNIT B, GLEN CARBON, IL 62034-1140
(309) 318-1421
Mailing address
254 W MAIN ST, UNIT B, GLEN CARBON, IL 62034-1140
(309) 318-1421
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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