Provider Demographics
NPI:1447692165
Name:VICKNAIR, KAYLA ZITO (LPC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ZITO
Last Name:VICKNAIR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 LAKE MACLAINE DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-1631
Mailing Address - Country:US
Mailing Address - Phone:225-485-2185
Mailing Address - Fax:
Practice Address - Street 1:1016 HOUMA ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4420
Practice Address - Country:US
Practice Address - Phone:985-873-8683
Practice Address - Fax:985-873-2597
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5044170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS