Provider Demographics
NPI:1538770771
Name:ROUTSONG, KAYLA MAY
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MAY
Last Name:ROUTSONG
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 1:361 N 700 E
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-3339
Mailing Address - Country:US
Mailing Address - Phone:719-331-6421
Mailing Address - Fax:
Practice Address - Street 1:1140 W. 1130 S.
Practice Address - Street 2:BUILDING B
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-2888
Practice Address - Country:US
Practice Address - Phone:801-935-4171
Practice Address - Fax:801-935-4946
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician