Provider Demographics
NPI:1255203261
Name:WASHINGTON, KALONI KAYLA
Entity type:Individual
Prefix:
First Name:KALONI
Middle Name:KAYLA
Last Name:WASHINGTON
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 1:2155 BEECHER RD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-2507
Mailing Address - Country:US
Mailing Address - Phone:336-287-8421
Mailing Address - Fax:
Practice Address - Street 1:2155 BEECHER RD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-2507
Practice Address - Country:US
Practice Address - Phone:336-287-8421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care