Mayberry, Kyler Dawn

Mayberry, Kyler Dawn is an sole proprietor health care provider with primary practice located at 3425 13Th St , Baker City OR 97814-1340. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Mayberry, Kyler Dawn can be contacted via phone (541) 523-7400.

Contact Information

Primary practice address
3425 13Th St Baker City OR 97814-1340
Phone: (541) 523-7400
Fax: (541) 523-4927
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X PENDING Oregon
Other Service Providers / Peer Specialist 175T00000X PENDING Oregon

Profile Details

NPI number 1760132807
LBN Legal business name Mayberry, Kyler Dawn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2022
Last updated Mar 23rd, 2022 - about 4 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 1760132807 NPPES
Oregon Other A434555 DRIVERS LICENSE

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