Healthcare Provider Details

I. General information

NPI: 1134743727
Provider Name (Legal Business Name): KYLA WRIGHT MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KYLA FORD

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date: 03/05/2024
Reactivation Date: 06/24/2026

III. Provider practice location address

2442 E MAPLE AVE
GRAND BLANC MI
48507-4462
US

IV. Provider business mailing address

5038 WISHING WELL DR
GRAND BLANC MI
48439-4238
US

V. Phone/Fax

Practice location:
  • Phone: 810-221-1663
  • Fax:
Mailing address:
  • Phone: 810-569-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101005397
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: