Healthcare Provider Details

I. General information

NPI: 1750200275
Provider Name (Legal Business Name): KAYLA DANIELLE HYMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 CAPCOM AVE STE 3
WAKE FOREST NC
27587-6517
US

IV. Provider business mailing address

5213 TRACKWAY DR
KNIGHTDALE NC
27545-9056
US

V. Phone/Fax

Practice location:
  • Phone: 984-289-3890
  • Fax:
Mailing address:
  • Phone: 240-893-6693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: