Provider Demographics
NPI:1679305908
Name:WAINWRIGHT, KAILA BRIANN
Entity type:Individual
Prefix:
First Name:KAILA
Middle Name:BRIANN
Last Name:WAINWRIGHT
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 1:15912 W PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-5853
Mailing Address - Country:US
Mailing Address - Phone:480-280-7391
Mailing Address - Fax:
Practice Address - Street 1:15912 W PARADISE LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-5853
Practice Address - Country:US
Practice Address - Phone:480-280-7391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician