Provider Demographics
NPI:1033523519
Name:ALFORD, KAYLEN MEREDITH (MS)
Entity Type:Individual
Prefix:
First Name:KAYLEN
Middle Name:MEREDITH
Last Name:ALFORD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5308 GOLDMINE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7305
Mailing Address - Country:US
Mailing Address - Phone:704-292-4672
Mailing Address - Fax:
Practice Address - Street 1:5308 GOLDMINE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7305
Practice Address - Country:US
Practice Address - Phone:704-292-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC5502OtherSC LLR SPEECH LANGUAGE PATHOLOGY