Individual
KAYLA KENNERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 HUGH WALLIS RD S STE B2, LAFAYETTE, LA 70508-2528
(337) 205-4444
Mailing address
1003 HUGH WALLIS RD S STE B2, LAFAYETTE, LA 70508-2528
(337) 205-4444
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
010590457
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-3121002
MENTAL HEALTH
LA
Enumeration date
10/01/2018
Last updated
04/16/2019
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