Most Relevant Information
Provider Data
| NPI Number: | 1003359860 |
| Provider Name: | KAYLIE PHELPS |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 3587 |
Most Important Dates
| Enumeration Date: | 11/28/2016 |
| Last Updated: | 06/20/2019 |
Provider Practice Location
93 EDWARDS ST
NEW HAVEN
CT
065113933
Practice Location Phone/Fax
| Phone: | 2037721270 |
| Fax: |
Provider Mailing Location
400 COLUMBUS AVENUE
CREDENTIALING SPECIALIST
NEW HAVEN
CT
065191233
Provider Mailing Phone/Fax
| Phone: | 2035033174 |
| Fax: | 2035036515 |