Basic Information
| Provider Information | |||||||||
| NPI: | 1760849533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DRAPALLA | ||||||||
| FirstName: | KAYLEA | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1222 10TH ST | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | WOODWARD | ||||||||
| State: | OK | ||||||||
| PostalCode: | 738013156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802568615 | ||||||||
| FaxNumber: | 5802568609 | ||||||||
| Practice Location | |||||||||
| Address1: | 702 N GRAND ST | ||||||||
| Address2: | |||||||||
| City: | ENID | ||||||||
| State: | OK | ||||||||
| PostalCode: | 737013221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802343791 | ||||||||
| FaxNumber: | 5802377711 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2016 | ||||||||
| LastUpdateDate: | 01/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 4783 | OK | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.