Provider Demographics
NPI:1174971881
Name:GERWIG, KAYLA (MS, CGC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:GERWIG
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:BOGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:PO BOX 841
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:WV
Mailing Address - Zip Code:26143-0841
Mailing Address - Country:US
Mailing Address - Phone:844-362-6567
Mailing Address - Fax:
Practice Address - Street 1:168 AMOS ACRES DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:WV
Practice Address - Zip Code:26143
Practice Address - Country:US
Practice Address - Phone:304-917-1432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2024-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000963170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS