Doctor Name: | MS. KAYLA A ALDERMAN |
NPI Number: | 1124387485 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | |
Business Practice Address: | 727 E Etna Rd Ottawa, IL - 613501040 |
Business Phone Number: | 8154344727 |
Business Fax Number: | 8154340271 |
Mailing Address: | 2960 Chartres St, P.o. Box 1488 LA SALLE |
State: | IL |
Postal Code: | 613011097 |
Phone Number: | 8152241610 |
Fax Number: | 8152231634 |
NPI Enumeration Date: | 05/08/2012 |
NPI Last Update Date: | 05/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |