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NPI Code Detail

MEDICARE: KAYLA ROSE DEVINE M.A., CCC-SLP

MEDICARE: KAYLA ROSE DEVINE M.A., CCC-SLP
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 PathologistLL608868431WA

General Provider Information

NPI Number : 1457832644
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ROSE DEVINE M.A., CCC-SLP
Provider Business Mailing Address
First Line : 711 SHORTRIDGE AVE
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-5146
Country : US
Telephone Number : 248-229-9358
Fax Number :
Provider Business Practice Location Address
First Line : 2320 BORST AVE
Second Line :
City : CENTRALIA
State : WA
Zip : 98531-1410
Country : US
Telephone Number : 248-229-9358
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2018
Last Update Date : 08/24/2018

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Directions to “ KAYLA ROSE DEVINE M.A., CCC-SLP” Practice Location

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