Healthcare Provider Details

I. General information

NPI: 1346158466
Provider Name (Legal Business Name): KAYLA JUSTINE BIRDD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 28TH ST S
LA CROSSE WI
54601-7928
US

IV. Provider business mailing address

2405 TRAVIS ST
LA CROSSE WI
54601-6835
US

V. Phone/Fax

Practice location:
  • Phone: 608-789-7767
  • Fax:
Mailing address:
  • Phone: 608-789-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: