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NPI Code Detail

MEDICARE: KAYLA ELIZABETH MCCONNELL

MEDICARE: KAYLA ELIZABETH MCCONNELL
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
1235Z00000XSpeech-Language PathologistIN

General Provider Information

NPI Number : 1376156836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ELIZABETH MCCONNELL
Provider Business Mailing Address
First Line : 8742 PHEASANT RUN CT
Second Line :
City : CLAYTON
State : IN
Zip : 46118-8830
Country : US
Telephone Number : 219-707-6199
Fax Number :
Provider Business Practice Location Address
First Line : 2640 COLD SPRING RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-2272
Country : US
Telephone Number : 317-923-1518
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2020
Last Update Date : 08/27/2020

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Directions to “ KAYLA ELIZABETH MCCONNELL ” Practice Location

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