Provider Demographics
NPI:1861065195
Name:COLE, KAYLA MARIE (BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:COLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12803 WEST AVE APT 14301
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1855
Mailing Address - Country:US
Mailing Address - Phone:253-381-8209
Mailing Address - Fax:
Practice Address - Street 1:600 N LOOP 1604 E
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1268
Practice Address - Country:US
Practice Address - Phone:210-239-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-24-73617103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst