Provider Demographics
NPI:1316553449
Name:DUB, KAYLA ANN (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:ANN
Last Name:DUB
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:DR
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:DUB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:4625 E BAY DR STE 305
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-5747
Mailing Address - Country:US
Mailing Address - Phone:279-533-4917
Mailing Address - Fax:
Practice Address - Street 1:4625 E BAY DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-5738
Practice Address - Country:US
Practice Address - Phone:727-953-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2347231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist