Provider Demographics
NPI:1003351784
Name:BLOOM-TROSKY, KAYLA (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BLOOM-TROSKY
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 5TH STREET HOLLOW RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-7757
Mailing Address - Country:US
Mailing Address - Phone:570-784-8050
Mailing Address - Fax:570-784-8058
Practice Address - Street 1:2449 STATE ROUTE 118
Practice Address - Street 2:
Practice Address - City:HUNLOCK CREEK
Practice Address - State:PA
Practice Address - Zip Code:18621-5022
Practice Address - Country:US
Practice Address - Phone:570-733-3112
Practice Address - Fax:833-277-9264
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006466231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist