Provider Demographics
NPI:1003535238
Name:MADSEN, KYLIE RAE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:RAE
Last Name:MADSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 JOSHUA DR
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-9544
Mailing Address - Country:US
Mailing Address - Phone:801-589-2612
Mailing Address - Fax:
Practice Address - Street 1:415 JOSHUA DR
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-9544
Practice Address - Country:US
Practice Address - Phone:801-589-2612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist