Provider Demographics
NPI:1154821692
Name:COREIL, KAYLA NICOLE
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:NICOLE
Last Name:COREIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:NICOLE
Other - Last Name:BERGERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. DRAWER 520
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70511
Mailing Address - Country:US
Mailing Address - Phone:337-893-3887
Mailing Address - Fax:
Practice Address - Street 1:220 S. JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510
Practice Address - Country:US
Practice Address - Phone:337-857-3744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist