MEDICARE: KAYLA MCCOURT

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	235Z00000X	Speech-Language Pathologist	SP-2167	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SP-2167	OTHER	NV	NEVADA BOARD OF AUDIOLOGY AND SPEECH PATHOLOGY

General Provider Information

NPI Number	:	1861024333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MCCOURT

Provider Business Mailing Address
First Line	:	9436 STEEPLEHILL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7270
Country	:	US
Telephone Number	:	702-286-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	9436 STEEPLEHILL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7270
Country	:	US
Telephone Number	:	702-286-3061
Fax Number	:

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

Provider Enumeration Date	:	02/12/2020
Last Update Date	:	11/27/2023

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Directions to “ KAYLA MCCOURT ” Practice Location

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