Provider Demographics
NPI:1245128792
Name:ROJO, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:ROJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5645 DUDLEY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-2645
Mailing Address - Country:US
Mailing Address - Phone:313-738-8418
Mailing Address - Fax:
Practice Address - Street 1:20700 CIVIC CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4102
Practice Address - Country:US
Practice Address - Phone:800-385-1035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician