Provider Demographics
NPI:1245127232
Name:VAN HOOSEAR, KAYLA RICHELLE LEE
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:RICHELLE LEE
Last Name:VAN HOOSEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KAYLA
Other - Middle Name:RICHELLE LEE
Other - Last Name:SALINAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1649 61ST ST FL 3013
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1924 E 32ND ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1870
Practice Address - Country:US
Practice Address - Phone:308-641-2692
Practice Address - Fax:308-641-2692
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician