Individual provider · NPI-1

Kayla Black

Nutritionist · Colorado Springs, CO

NPI number1689374415
StatusActive
Last updated in NPPESMar 9, 2023

Details

NPI
1689374415
Entity type
Individual (NPI-1)
Name
Kayla Black
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 9, 2023
Certification date
Mar 9, 2023
Last updated
Mar 9, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133N00000X Nutritionist–TXYes

Practice location

7712 Bannockburn Trl
Colorado Springs, CO 80908-4845

Phone 832-922-2414

Mailing address

7712 Bannockburn Trl
Colorado Springs, CO 80908-4845

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