Healthcare Provider Details

I. General information

NPI: 1538773007
Provider Name (Legal Business Name): KAYLA ROSE WINKLER M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2951 S 34TH ST
GRAND FORKS ND
58201-6061
US

IV. Provider business mailing address

2951 S 34TH ST
GRAND FORKS ND
58201-6061
US

V. Phone/Fax

Practice location:
  • Phone: 701-772-3851
  • Fax: 701-772-3852
Mailing address:
  • Phone: 701-772-3851
  • Fax: 701-772-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2020023094
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3082
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: