KAYLA ANN JACK
NPI 1093498578
Social Worker - School in Shiprock, NM
Active since August 10, 2023
About Kayla Ann Jack NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAYLA ANN JACK (NPI 1093498578) is an individual school provider in Shiprock, New Mexico, licensed in New Mexico (SWB-2023-0550) and active in the NPI registry since August 2023.
NPPES Registry Identity
NPI1093498578
Entity TypeIndividualFemale
Primary Taxonomy1041S0200X
Provider Legal NameKAYLA ANN JACK
Location AddressUS 491Shiprock, NM 87420
Mailing AddressPo Box 5036Shiprock, NM 87420-5036 · (505) 419-0294
Phone(505) 419-0294
Sole ProprietorYes
Enumeration DateAugust 10, 2023
Last NPPES UpdateSeptember 8, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2023
✔ NPI 1093498578 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtySocial Worker · SchoolBehavioral Health & Social Service Providers
Taxonomy Code1041S0200X
License✔ Licensed in NM · SWB-2023-0550
US 491, Shiprock, NM 87420
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093498578, enumerated as an "individual" on August 10, 2023.
The provider is located at US 491 SHIPROCK, NM 87420 and the phone number is (505) 419-0294.
Social Worker with taxonomy code 1041S0200X and a focus in School.
