MEDICARE: KAYLA SPEICHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0700X	Hearing and Speech Clinic/Center

General Provider Information

NPI Number	:	1669196903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA SPEICHER

Provider Business Mailing Address
First Line	:	21524 E FREEDOM DR
Second Line	:
City	:	RED ROCK
State	:	AZ
Zip	:	85145-6052
Country	:	US
Telephone Number	:	520-603-4676
Fax Number	:

Provider Business Practice Location Address
First Line	:	21524 E FREEDOM DR
Second Line	:
City	:	RED ROCK
State	:	AZ
Zip	:	85145-6052
Country	:	US
Telephone Number	:	520-603-4676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2022
Last Update Date	:	09/29/2022

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Directions to “ KAYLA SPEICHER ” Practice Location

Language	Start Address	Practice Location

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