Provider Demographics
NPI:1164254900
Name:MARTE, KAYLA L
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:L
Last Name:MARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8224 135TH ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1356
Mailing Address - Country:US
Mailing Address - Phone:646-637-2482
Mailing Address - Fax:
Practice Address - Street 1:15 MACDONOUGH ST # 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-2303
Practice Address - Country:US
Practice Address - Phone:347-475-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health