Provider Demographics
NPI:1508681834
Name:GAHMAN, KAILYNN
Entity type:Individual
Prefix:
First Name:KAILYNN
Middle Name:
Last Name:GAHMAN
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 1:1245 KUNKLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:SAYLORSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18353-7775
Mailing Address - Country:US
Mailing Address - Phone:717-693-1182
Mailing Address - Fax:
Practice Address - Street 1:1245 KUNKLETOWN RD
Practice Address - Street 2:
Practice Address - City:SAYLORSBURG
Practice Address - State:PA
Practice Address - Zip Code:18353-7775
Practice Address - Country:US
Practice Address - Phone:717-693-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional