Provider Demographics
NPI:1083331581
Name:NEWCOMB, KAYLA LEE (SLP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LEE
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 HIGHLANDER POINT DR
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-9442
Mailing Address - Country:US
Mailing Address - Phone:502-430-1942
Mailing Address - Fax:
Practice Address - Street 1:708 HIGHLANDER POINT DR
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-9442
Practice Address - Country:US
Practice Address - Phone:502-430-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2007855A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN22007855AOtherPROFESSIONAL LICENSING BOARD