Provider Demographics
NPI:1003561168
Name:WOOD, KAYLA MACK (BCBA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MACK
Last Name:WOOD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 BRISBANE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4923
Mailing Address - Country:US
Mailing Address - Phone:844-272-7223
Mailing Address - Fax:
Practice Address - Street 1:121 VISION PARK BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3028
Practice Address - Country:US
Practice Address - Phone:844-272-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8696103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst