MEDICARE: DARCI KAYLA KERN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2020023089	MO

General Provider Information

NPI Number	:	1104583772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARCI KAYLA KERN

Provider Business Mailing Address
First Line	:	12110 CLAYTON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63131-2599
Country	:	US
Telephone Number	:	314-540-7913
Fax Number	:

Provider Business Practice Location Address
First Line	:	3144 LACKLAND AVE # 2F
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-2020
Country	:	US
Telephone Number	:	314-540-7913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	11/18/2021

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Directions to “ DARCI KAYLA KERN ” Practice Location

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