Healthcare Provider Details

I. General information

NPI: 1841973898
Provider Name (Legal Business Name): KAYLEE MITCHELL B.S., SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E CRANDALL AVE STE A
HARRISON AR
72601-3629
US

IV. Provider business mailing address

265 BUZZ ST UNIT 16
BRANSON MO
65616-6730
US

V. Phone/Fax

Practice location:
  • Phone: 870-654-3869
  • Fax: 870-505-2016
Mailing address:
  • Phone: 417-527-0523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number2021036471
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number202373
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: