Provider Demographics
NPI:1366239576
Name:DONAHOO, KAYRA
Entity type:Individual
Prefix:
First Name:KAYRA
Middle Name:
Last Name:DONAHOO
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 1:131 WRIGHT CIR
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-4231
Mailing Address - Country:US
Mailing Address - Phone:850-273-4706
Mailing Address - Fax:239-402-9217
Practice Address - Street 1:131 WRIGHT CIR
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-4231
Practice Address - Country:US
Practice Address - Phone:850-273-4706
Practice Address - Fax:239-402-9217
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-20-123157106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician