Broeker, Kyla

Broeker, Kyla is an individual health care provider with primary practice located at 47 Ellis Ave , Troy MO 63379-1151. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Broeker, Kyla can be contacted via phone (636) 357-1996.

Contact Information

Primary practice address
47 Ellis Ave Troy MO 63379-1151
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2002010834 Missouri

Profile Details

NPI number 1295874584
LBN Legal business name Broeker, Kyla
Credentials MA, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Jun 21st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295874584 NPPES
Missouri MEDICAID 495771313

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