| Doctor Name: | KAYLA AVERY |
| NPI Number: | 1366878118 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC-MHSP |
| License Number: | 2990 |
| Business Practice Address: | Bldg 2516 22nd St. Ft. Campbell, KY - 422235650 |
| Business Phone Number: | 2707980900 |
| Business Fax Number: | |
| Mailing Address: | Bldg 2516 22nd St., FT. CAMPBELL |
| State: | KY |
| Postal Code: | 422235650 |
| Phone Number: | 2707980900 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2013 |
| NPI Last Update Date: | 12/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2990 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |