Provider Demographics
NPI:1043709843
Name:MCSWAIN, KAYLA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MCSWAIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 E BOOKER DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9405
Mailing Address - Country:US
Mailing Address - Phone:919-938-3824
Mailing Address - Fax:
Practice Address - Street 1:1660 E BOOKER DAIRY RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9405
Practice Address - Country:US
Practice Address - Phone:919-938-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-17-41854106S00000X
NC14654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty