MEDICARE: KAYLA RENAE FLANAGAN

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	9388	SC

General Provider Information

NPI Number	:	1851279160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA RENAE FLANAGAN

Provider Business Mailing Address
First Line	:	2557 PEMBROKE RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-4712
Country	:	US
Telephone Number	:	980-320-8275
Fax Number	:

Provider Business Practice Location Address
First Line	:	1308 VILLAGE HARBOR DR
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-9095
Country	:	US
Telephone Number	:	980-320-8275
Fax Number	:	704-973-7862

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “ KAYLA RENAE FLANAGAN ” Practice Location

Language	Start Address	Practice Location

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