Provider Demographics
NPI:1164112058
Name:BRYANT, KAYLA MAREE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MISS
First Name:KAYLA
Middle Name:MAREE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAHAN LN
Mailing Address - Street 2:
Mailing Address - City:FOLLANSBEE
Mailing Address - State:WV
Mailing Address - Zip Code:26037-1034
Mailing Address - Country:US
Mailing Address - Phone:304-914-5420
Mailing Address - Fax:
Practice Address - Street 1:38095 OH-39
Practice Address - Street 2:
Practice Address - City:SALINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43945
Practice Address - Country:US
Practice Address - Phone:330-679-2343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15253235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist