Individual
KAYLA IMANI EDING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2833 CHARIOT LN, OLYMPIA FIELDS, IL 60461-1512
(616) 566-0770
Mailing address
2833 CHARIOT LN, OLYMPIA FIELDS, IL 60461-1512
(616) 566-0770
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904019977
VA
106S00000X
Behavior Technician
Primary
—
MI
Other
Enumeration date
12/25/2019
Last updated
04/09/2026
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