Healthcare Provider Details

I. General information

NPI: 1104744135
Provider Name (Legal Business Name): KAYLA MARIE BONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 CHENEY AVE S
LEHIGH ACRES FL
33974-4868
US

IV. Provider business mailing address

1044 CHENEY AVE S
LEHIGH ACRES FL
33974-4868
US

V. Phone/Fax

Practice location:
  • Phone: 239-503-0760
  • Fax:
Mailing address:
  • Phone: 239-503-0760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI6768
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: